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General NPI Number Information
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NPI Number | 1134480858
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Entity Type | Individual
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Provider Name | FASIKA BERHANU ABERRA M.D.
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Gender | Female
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Dates
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Enumeration Date | 05/30/2012
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Last Update Date | 04/12/2023
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Provider Practice Location Address
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Address Line | 130 HOSPITAL RD STE 300
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City | PRINCE FREDERICK
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State | MD
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Zip | 20678-4057
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Country | US
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Telephone | 410-535-4333
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Fax | 410-535-3260
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Provider Business Mailing Address
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Address Line | PO BOX 1430
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City | HARRISONBURG
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State | VA
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Zip | 22803-1430
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Country | US
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Telephone | 540-564-5800
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Fax | 833-552-3026
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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 | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | 51366
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | D96613
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License Number State | MD
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Taxonomy #3
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 51366
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License Number State | TN
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Taxonomy #4
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | 0101266585
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License Number State | VA
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