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General NPI Number Information
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NPI Number | 1427690809
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Entity Type | Individual
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Provider Name | AWEKE YILMA DUBI
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Gender | Male
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Dates
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Enumeration Date | 10/17/2019
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Last Update Date | 11/20/2021
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Provider Practice Location Address
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Address Line | 815 E PRATT ST
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City | BALTIMORE
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State | MD
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Zip | 21202-4889
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Country | US
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Telephone | 571-275-1061
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Fax |
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Provider Business Mailing Address
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Address Line | 7141 SECURITY BLVD
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City | BALTIMORE
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State | MD
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Zip | 21244-1811
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Country | US
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Telephone | 703-359-7878
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | R211567
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | R211567
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License Number State | MD
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