Provider Demographics
NPI:1871281790
Name:SHIBESHI, ESKINDR DESSALEGN
Entity type:Individual
Prefix:
First Name:ESKINDR
Middle Name:DESSALEGN
Last Name:SHIBESHI
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 1:1001 S HAVANA ST APT 212
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80012-2904
Mailing Address - Country:US
Mailing Address - Phone:720-939-1998
Mailing Address - Fax:
Practice Address - Street 1:1001 S HAVANA ST APT 212
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80012-2904
Practice Address - Country:US
Practice Address - Phone:720-939-1998
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-27
Last Update Date:2023-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO132420976343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)