1831154376 NPI number — DR. GEBREHANA WOLDESENBET ZEBRO MD

Table of content: DR. GEBREHANA WOLDESENBET ZEBRO MD (NPI 1831154376)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1831154376 NPI number — DR. GEBREHANA WOLDESENBET ZEBRO MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ZEBRO
Provider First Name:
GEBREHANA
Provider Middle Name:
WOLDESENBET
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
WOLDEGIORGIS
Provider Other First Name:
GEBREHANA
Provider Other Middle Name:
WOLDESEMIAT
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
M.D
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1831154376
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/20/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2000 HEALTH PARK DR FL HP2
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BRENTWOOD
Provider Business Mailing Address State Name:
TN
Provider Business Mailing Address Postal Code:
37027-4525
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
615-373-7600
Provider Business Mailing Address Fax Number:
877-767-2310

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1 ARH LANE
Provider Second Line Business Practice Location Address:
5TH FLOOR TRANSITIONAL UNIT
Provider Business Practice Location Address City Name:
LOW MOOR
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
24457
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
540-862-2021
Provider Business Practice Location Address Fax Number:
540-862-6715
Provider Enumeration Date:
04/18/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207R00000X , with the licence number:  0101239027 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2084P0800X , with the licence number: 0101239027 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2084P0800X , with the licence number: 15187 , registered in the state of ND ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2084P0805X , with the licence number: 0101239027 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)