MEDICARE: DR. GEDION ATNAFU 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	207RI0200X	Infectious Disease Physician	D0062148	MD
2	208M00000X	Hospitalist Physician	D62148	MD
3	207RI0200X	Infectious Disease Physician	D62148	MD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	647076-01	OTHER	MD	BLUE CROSS/BLUE SHIELD
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1326006578
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GEDION ATNAFU M.D.

Provider Business Mailing Address
First Line	:	7845 OAKWOOD RD
Second Line	:	STE 105
City	:	GLEN BURNIE
State	:	MD
Zip	:	21061-4256
Country	:	US
Telephone Number	:	410-650-4100
Fax Number	:	877-648-1188

Provider Business Practice Location Address
First Line	:	12701 TRUTHS PROMISE CT
Second Line	:
City	:	BOWIE
State	:	MD
Zip	:	20720-5600
Country	:	US
Telephone Number	:	410-650-4100
Fax Number	:	877-648-1188

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

Provider Enumeration Date	:	05/03/2006
Last Update Date	:	05/10/2022

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