Healthcare Provider Details

I. General information

NPI: 1811803471
Provider Name (Legal Business Name): ADDISALEM DESSISSA TOLOSSA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/21/2026
Last Update Date: 09/03/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2909 CALVERTON BLVD
SILVER SPRING MD
20904-1833
US

IV. Provider business mailing address

2909 CALVERTON BLVD
SILVER SPRING MD
20904-1833
US

V. Phone/Fax

Practice location:
  • Phone: 202-480-1280
  • Fax:
Mailing address:
  • Phone: 202-480-1280
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171W00000X
TaxonomyContractor
License Number
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: