Healthcare Provider Details

I. General information

NPI: 1306163373
Provider Name (Legal Business Name): ABERA BEKELE WOLDESENBET M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/29/2010
Last Update Date: 09/03/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8118 GOOD LUCK RD
LANHAM MD
20706-3574
US

IV. Provider business mailing address

7503 SURRATTS RD DEPT OF MEDICINE
CLINTON MD
20735-3358
US

V. Phone/Fax

Practice location:
  • Phone: 240-686-2300
  • Fax: 240-686-2330
Mailing address:
  • Phone: 240-429-3904
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberD0079557
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberD79557
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: