MEDICARE: ABRAHAM BAKE DABELA 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	207RN0300X	Nephrology Physician	MD9880	DC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	04794	OTHER	MD	AMERIGROUP
2	7596 0001	OTHER	MD	CAREFIRST BLUECROSS BLUES
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1518972306
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ABRAHAM BAKE DABELA M.D.

Provider Business Mailing Address
First Line	:	6810 MELODY LN
Second Line	:
City	:	BETHESDA
State	:	MD
Zip	:	20817-2923
Country	:	US
Telephone Number	:	301-469-4856
Fax Number	:

Provider Business Practice Location Address
First Line	:	4404 QUEENSBURY RD
Second Line	:
City	:	RIVERDALE
State	:	MD
Zip	:	20737-1068
Country	:	US
Telephone Number	:	301-779-1949
Fax Number	:	301-699-1703

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

Provider Enumeration Date	:	07/30/2006
Last Update Date	:	07/09/2007

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