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General NPI Number Information
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NPI Number | 1679503064
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Entity Type | Organization
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Legal Business Name | MEKLIT WORKNEH,MD, PA
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Dates
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Enumeration Date | 07/03/2006
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Last Update Date | 08/07/2014
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Provider Practice Location Address
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Address Line | 7705 BELLE POINT DR
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City | GREENBELT
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State | MD
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Zip | 20770-3300
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Country | US
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Telephone | 301-220-1371
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Fax | 301-220-1372
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Provider Business Mailing Address
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Address Line | 13305 BIG CEDAR LN
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City | BOWIE
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State | MD
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Zip | 20720-5609
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Country | US
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Telephone | 301-860-1195
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Fax | 301-220-1372
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Authorized Official
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Title or Position | SOLE PROPRIETOR
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Name | MEKLIT WORKNEH
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Credential | M.D.
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Telephone | 301-220-1371
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | D0062116
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License Number State | MD
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