Healthcare Provider Details

I. General information

NPI: 1194220558
Provider Name (Legal Business Name): JALEL ABERA HUNDE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/28/2018
Last Update Date: 10/01/2026
Certification Date: 10/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

945 N. 12TH STREET
MILWAUKEE WI
53201
US

IV. Provider business mailing address

2100 SAINT JOSEPHS DR
MITCHELLVILLE MD
20721-1891
US

V. Phone/Fax

Practice location:
  • Phone: 469-528-5136
  • Fax:
Mailing address:
  • Phone: 469-528-5136
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number72664-20
License Number StateWI
# 2
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number72664-20
License Number StateWI
# 3
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number72664
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: