MEDICARE: DR. TSION BERHANE MD

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	2086S0102X	Surgical Critical Care Physician	D0055703	MD
2	208600000X	Surgery Physician	D0055703	MD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	CC2108342	OTHER	MD	MAMSI CRITICAL CARE

General Provider Information

NPI Number	:	1255336962
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TSION BERHANE MD

Provider Business Mailing Address
First Line	:	604 MISSION HILLS CT
Second Line	:
City	:	SILVER SPRING
State	:	MD
Zip	:	20905-8020
Country	:	US
Telephone Number	:	410-997-5944
Fax Number	:	443-445-3392

Provider Business Practice Location Address
First Line	:	604 MISSION HILLS CT
Second Line	:
City	:	SILVER SPRING
State	:	MD
Zip	:	20905-8020
Country	:	US
Telephone Number	:	410-997-5944
Fax Number	:	443-445-3392

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

Provider Enumeration Date	:	06/17/2005
Last Update Date	:	10/15/2009

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