Provider Demographics
NPI:1316674849
Name:WELDE, SELAM HAILU
Entity type:Individual
Prefix:
First Name:SELAM
Middle Name:HAILU
Last Name:WELDE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6919 18TH AVE
Mailing Address - Street 2:
Mailing Address - City:HYATTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20783-2958
Mailing Address - Country:US
Mailing Address - Phone:301-809-7220
Mailing Address - Fax:
Practice Address - Street 1:414 W ST NW APT 11
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20001-2313
Practice Address - Country:US
Practice Address - Phone:202-468-0960
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-04
Last Update Date:2022-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant