Provider Demographics
NPI:1730981200
Name:NEGASH, MUSSIE
Entity type:Individual
Prefix:DR
First Name:MUSSIE
Middle Name:
Last Name:NEGASH
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 1:1039 S PARKER RD APT Q5
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80231-2589
Mailing Address - Country:US
Mailing Address - Phone:720-436-4887
Mailing Address - Fax:
Practice Address - Street 1:1039 S PARKER RD APT Q5
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80231-2589
Practice Address - Country:US
Practice Address - Phone:720-436-4887
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-26
Last Update Date:2025-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0023018183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist