Healthcare Provider Details

I. General information

NPI: 1326989997
Provider Name (Legal Business Name): GELILA WONDIMAGEGN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/06/2026
Last Update Date: 04/06/2026
Certification Date: 04/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

817 SILVER SPRING AVE STE 304
SILVER SPRING MD
20910-4617
US

IV. Provider business mailing address

2809 SCHUBERT DR
SILVER SPRING MD
20904-6882
US

V. Phone/Fax

Practice location:
  • Phone: 227-282-9179
  • Fax:
Mailing address:
  • Phone: 227-282-9179
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171R00000X
TaxonomyInterpreter
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: