MEDICARE: KEDIJA HAYATO HEDARA M.D

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208M00000X	Hospitalist Physician	D84864	MD
2	207R00000X	Internal Medicine Physician	D84864	MD
3	207R00000X	Internal Medicine Physician	1178307	MD

General Provider Information

NPI Number	:	1154717601
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KEDIJA HAYATO HEDARA M.D

Provider Business Mailing Address
First Line	:	6735 NEW HAMPSHIRE AVE APT 702
Second Line	:
City	:	TAKOMA PARK
State	:	MD
Zip	:	20912-4850
Country	:	US
Telephone Number	:	720-519-6318
Fax Number	:

Provider Business Practice Location Address
First Line	:	2041 GEORGIA AVE NW
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20060-0001
Country	:	US
Telephone Number	:	720-519-6318
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/11/2015
Last Update Date	:	02/03/2026

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