NPI 1124574579

Fitsum Abreha, CROSSDMESUPPLIER

Practitioner Driver Phoenix, AZ

Practice location

Address: 4760 N 28th St, Phoenix, AZ 85016-4846
Phone: (480) 277-1016
Mailing address: 4760 N 28th Street, Phoenix, AZ 85339

Registered specialties

Driver Primary

Other Service Providers Taxonomy 172A00000X

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Registry record

NPI: 1124574579
Entity type: Individual
Sex (as registered): Male
NPI issued: 26 Aug 2016
Record last updated: 26 Aug 2016

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.