Healthcare Provider Details

I. General information

NPI: 1093009805
Provider Name (Legal Business Name): ZEWDI ANESTHESIA, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/09/2011
Last Update Date: 06/09/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7300 HANOVER DR SUITE 204
GREENBELT MD
20770-2202
US

IV. Provider business mailing address

7300 HANOVER DR SUITE 204
GREENBELT MD
20770-2202
US

V. Phone/Fax

Practice location:
  • Phone: 301-220-2333
  • Fax: 301-220-2339
Mailing address:
  • Phone: 301-220-2333
  • Fax: 301-220-2339

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. NETSERE TESFAYOHANNES
Title or Position: OWNER
Credential: M.D., ABA, ABAP
Phone: 301-220-2333