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General NPI Number Information
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NPI Number | 1548780315
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Entity Type | Individual
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Provider Name | DEREJE HAILEMARIAM HABITEMICHAEL MD
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Gender | Male
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Dates
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Enumeration Date | 06/22/2017
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Last Update Date | 12/16/2025
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Provider Practice Location Address
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Address Line | 100 E CARROLL ST
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City | SALISBURY
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State | MD
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Zip | 21801-5422
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Country | US
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Telephone | 410-546-6400
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Fax |
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Provider Business Mailing Address
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Address Line | 100 E CARROLL ST
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City | SALISBURY
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State | MD
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Zip | 21801-5422
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Country | US
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Telephone | 410-546-6400
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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 | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | 0101275485
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | D0089718
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License Number State | MD
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Taxonomy #3
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | 340963
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License Number State | LA
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Taxonomy #4
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | C2393
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License Number State | KY
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