Provider Demographics
NPI:1174357784
Name:TESFAYE, EMNET (RDMS, RVT)
Entity type:Individual
Prefix:
First Name:EMNET
Middle Name:
Last Name:TESFAYE
Suffix:
Gender:F
Credentials:RDMS, RVT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2114 BISHOPS CASTLE DR
Mailing Address - Street 2:
Mailing Address - City:OLNEY
Mailing Address - State:MD
Mailing Address - Zip Code:20832-1645
Mailing Address - Country:US
Mailing Address - Phone:301-641-5799
Mailing Address - Fax:
Practice Address - Street 1:2114 BISHOPS CASTLE DR
Practice Address - Street 2:
Practice Address - City:OLNEY
Practice Address - State:MD
Practice Address - Zip Code:20832-1645
Practice Address - Country:US
Practice Address - Phone:301-641-5799
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-27
Last Update Date:2024-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD1754152085U0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085U0001XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Ultrasound