Healthcare Provider Details

I. General information

NPI: 1922929363
Provider Name (Legal Business Name): BIRHANU E WORKIE
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/22/2026
Last Update Date: 07/22/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11235 OAK LEAF DR APT 1604
SILVER SPRING MD
20901-1304
US

IV. Provider business mailing address

11235 OAK LEAF DR APT 1604
SILVER SPRING MD
20901-1304
US

V. Phone/Fax

Practice location:
  • Phone: 240-381-3215
  • Fax:
Mailing address:
  • Phone: 240-381-3215
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License NumberAC009360
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: