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General NPI Number Information
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NPI Number | 1831564319
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Entity Type | Individual
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Provider Name | TSEHAYE GESESEW
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Gender | Male
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Dates
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Enumeration Date | 12/09/2015
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Last Update Date | 04/25/2025
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Provider Practice Location Address
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Address Line | 6023 TURNABOUT LN
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City | COLUMBIA
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State | MD
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Zip | 21044-3058
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Country | US
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Telephone | 240-505-5328
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Fax |
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Provider Business Mailing Address
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Address Line | 6023 TURNABOUT LN
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City | COLUMBIA
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State | MD
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Zip | 21044-3058
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Country | US
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Telephone | 240-505-5328
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | C05936
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | C0005936
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License Number State | MD
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