Healthcare Provider Details

I. General information

NPI: 1093965584
Provider Name (Legal Business Name): MAHETEME BAYEH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/22/2008
Last Update Date: 10/08/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9801 GREENBELT RD SUITE 101
LANHAM MD
20706-2273
US

IV. Provider business mailing address

9801 GREENBELT RD SUITE 101
LANHAM MD
20706-2273
US

V. Phone/Fax

Practice location:
  • Phone: 301-552-6666
  • Fax: 301-552-6216
Mailing address:
  • Phone: 301-552-6666
  • Fax: 301-552-6216

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License NumberDO54579
License Number StateMD

VIII. Authorized Official

Name: MAHETEME BAYEH
Title or Position: PHYSICIAN
Credential: M.D
Phone: 240-997-1680