Healthcare Provider Details

I. General information

NPI: 1649915182
Provider Name (Legal Business Name): HERMOON ALEMAYEHU WORKU MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/29/2022
Last Update Date: 08/27/2026
Certification Date: 08/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

75 FRANCIS ST
BOSTON MA
02115-6110
US

IV. Provider business mailing address

2424 ALLEQUIPPA ST
PITTSBURGH PA
15213-2324
US

V. Phone/Fax

Practice location:
  • Phone: 678-362-2884
  • Fax:
Mailing address:
  • Phone: 678-362-2884
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number1027298
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: