Individual
FISSEHA YITBAREK GHIDEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D
Contact information
Practice address
4509 GARFIELD ST, HYATTSVILLE, MD 20781
(718) 710-1813
Mailing address
4509 GARFIELD ST, HYATTSVILLE, MD 20781-1963
(718) 710-1813
(253) 284-1881
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
0101251331
VA
207R00000X
Internal Medicine Physician
Primary
59991
WI
207R00000X
Internal Medicine Physician
D79362
MD
207R00000X
Internal Medicine Physician
MD041448
DC
207RI0200X
Infectious Disease Physician
0101251331
VA
207RI0200X
Infectious Disease Physician
59991
WI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100045960
—
WI
05
—
1265485270
—
VA
Enumeration date
06/30/2009
Last updated
03/07/2024
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