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General NPI Number Information
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NPI Number | 1093029886
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Entity Type | Individual
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Provider Name | ADDISALEM TAYE MAKURIA M.D.
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Gender | Female
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Dates
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Enumeration Date | 08/04/2010
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Last Update Date | 11/24/2025
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Provider Practice Location Address
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Address Line | 3800 RESERVOIR RD NW
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City | WASHINGTON
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State | DC
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Zip | 20007-2113
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Country | US
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Telephone | 202-444-7599
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Fax | 202-444-3713
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Provider Business Mailing Address
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Address Line | 1 FEDERAL ST STE 200
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City | CAMDEN
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State | NJ
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Zip | 08103-1088
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Country | US
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Telephone | 848-288-6935
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207ZP0102X
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Taxonomy Name | Anatomic Pathology & Clinical Pathology Physician
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License Number | 25MA12924300
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | MD039172
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License Number State | DC
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Taxonomy #3
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Taxonomy Code | 207ZP0105X
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Taxonomy Name | Clinical Pathology/Laboratory Medicine Physician
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License Number | 2013-00065
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License Number State | NC
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Taxonomy #4
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Taxonomy Code | 207ZB0001X
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Taxonomy Name | Blood Banking & Transfusion Medicine Physician
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License Number | MD039172
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License Number State | DC
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