Individual
MS. METTASSEBIA KANNO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
10 HOPKINS PLZ, KAISER PERMANENTE CITY PLAZA MEDICAL CENTER, BALTIMORE, MD 21201-2900
(443) 263-7300
Mailing address
2101 E JEFFERSON ST, KAISER PERMANENTE MEDICARE ENROLLMENT, ROCKVILLE, MD 20852-4908
(301) 816-2424
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
237156
MA
207RI0200X
Infectious Disease Physician
Primary
D58251
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1043264492
—
DE
05
—
395000000
—
MD
01
—
617124-01
BLUE CROSS/BLUE SHIELD
MD
Enumeration date
05/20/2006
Last updated
01/20/2022
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