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General NPI Number Information
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NPI Number | 1598794646
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Entity Type | Individual
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Provider Name | ASHEBIR GEBRU WOLDEABEZGI MD
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Gender | Male
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Dates
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Enumeration Date | 07/01/2006
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Last Update Date | 10/10/2014
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Provider Practice Location Address
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Address Line | 11637 TERRACE DR SUITE 103
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City | WALDORF
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State | MD
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Zip | 20602-3706
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Country | US
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Telephone | 301-374-9725
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Fax | 301-374-9181
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Provider Business Mailing Address
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Address Line | 11637 TERRACE DR SUITE 103
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City | WALDORF
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State | MD
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Zip | 20602-3706
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Country | US
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Telephone | 301-374-9725
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Fax | 301-374-9181
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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 | 207RI0200X
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Taxonomy Name | Infectious Disease Physician
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License Number | D0062596
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License Number State | MD
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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 | D0062596
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License Number State | MD
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Taxonomy #3
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Taxonomy Code | 207RI0200X
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Taxonomy Name | Infectious Disease Physician
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License Number | 0101240403
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License Number State | VA
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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 | 0101240403
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License Number State | VA
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Taxonomy #5
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Taxonomy Code | 207RI0200X
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Taxonomy Name | Infectious Disease Physician
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License Number | MD035472
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License Number State | DC
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Taxonomy #6
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | MD035472
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License Number State | DC
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