1407953219 NPI number — ASHEBIR WOLDEABEZGI MD PC

Table of content: (NPI 1407953219)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1407953219 NPI number — ASHEBIR WOLDEABEZGI MD PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ASHEBIR WOLDEABEZGI MD PC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1407953219
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/20/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
11637 TERRACE DR
Provider Second Line Business Mailing Address:
SUITE 103
Provider Business Mailing Address City Name:
WALDORF
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
20602-3706
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
301-374-9725
Provider Business Mailing Address Fax Number:
301-374-9724

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
11637 TERRACE DR
Provider Second Line Business Practice Location Address:
SUITE 103
Provider Business Practice Location Address City Name:
WALDORF
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
20602-3706
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
301-374-9725
Provider Business Practice Location Address Fax Number:
301-374-9724
Provider Enumeration Date:
09/20/2006

Additional Information

Authorized Official

Authorized Official Last Name:
WOLDEABEZGI
Authorized Official First Name:
ASHEBIR
Authorized Official Middle Name:
GEBRU
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
301-374-9725

Provider Taxonomy Codes

  • Taxonomy code: 207R00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207RI0200X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 265824 . This is a "KAISER PERMANETE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 2159246 . This is a "MDIPA" identifier . This identifiers is of the category "OTHER".
  • Identifier: DG0925 . This is a "MEDICARE RAILROAD" identifier . This identifiers is of the category "OTHER".
  • Identifier: 29JGA . This is a "BCBS CAREFIRST" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 7031 . This is a "CAREFIRST FEDERAL" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1419486 . This is a "AETNA HMO" identifier . This identifiers is of the category "OTHER".
  • Identifier: 7223718 . This is a "AETNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 2159246 . This is a "MAMSI LIFE AND HEALTH" identifier . This identifiers is of the category "OTHER".
  • Identifier: 207251 . This is a "JOHNS HOPKINS MED SERVICE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 2159246 . This is a "ALLIANCE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 248267 . This is a "ANTHEM" identifier . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com