Provider Demographics
NPI:1982345179
Name:REDA, SOLOMON BIRUK
Entity type:Individual
Prefix:
First Name:SOLOMON
Middle Name:BIRUK
Last Name:REDA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18636 E VASSAR DR
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80013-6467
Mailing Address - Country:US
Mailing Address - Phone:720-400-4718
Mailing Address - Fax:
Practice Address - Street 1:18636 E VASSAR DR
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80013-6467
Practice Address - Country:US
Practice Address - Phone:720-400-4718
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-05
Last Update Date:2022-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347C00000XTransportation ServicesPrivate Vehicle