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NPI Code Detail

MEDICARE: DR. SAMUEL FEKADU ASFAW M.D.

MEDICARE: DR. SAMUEL FEKADU ASFAW 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
1207R00000XInternal Medicine PhysicianD0060611MD

General Provider Information

NPI Number : 1295742757
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SAMUEL FEKADU ASFAW M.D.
Provider Business Mailing Address
First Line : 8118 GOOD LUCK RD
Second Line : STE 300
City : LANHAM
State : MD
Zip : 20706-3574
Country : US
Telephone Number : 301-552-8130
Fax Number :
Provider Business Practice Location Address
First Line : 8118 GOOD LUCK RD
Second Line :
City : LANHAM
State : MD
Zip : 20706-3574
Country : US
Telephone Number : 301-552-8130
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/01/2006
Last Update Date : 11/08/2016

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