Nebiyu Jamal Fanta

NPI #1013498872 in Saint Paul, Minnesota

Provider Information

NPI Number: 1013498872
Entity Type: Individual
Name: Nebiyu Jamal Fanta
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Driver
Enumeration Date: Aug 28, 2018
Last Updated: Aug 28, 2018

Practice Location

Address: 478 UNIVERSITY AVE W
City: Saint Paul
State: Minnesota
ZIP Code: 55103-1935
Phone: (202) 779-8511

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Driver	172A00000X	Primary

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