Provider Demographics
NPI:1487941019
Name:TEWELDE, MONALIZA ZERABRUCK
Entity type:Individual
Prefix:
First Name:MONALIZA
Middle Name:ZERABRUCK
Last Name:TEWELDE
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 1:9139 RIGGS RD
Mailing Address - Street 2:
Mailing Address - City:ADELPHI
Mailing Address - State:MD
Mailing Address - Zip Code:20783-1637
Mailing Address - Country:US
Mailing Address - Phone:301-439-3232
Mailing Address - Fax:
Practice Address - Street 1:9139 RIGGS RD
Practice Address - Street 2:
Practice Address - City:ADELPHI
Practice Address - State:MD
Practice Address - Zip Code:20783-1637
Practice Address - Country:US
Practice Address - Phone:301-439-3232
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-04
Last Update Date:2011-07-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD16207183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist