Individual
FASIKA BERHANU ABERRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
130 HOSPITAL RD STE 300, PRINCE FREDERICK, MD 20678-4057
(410) 535-4333
(410) 535-3260
Mailing address
PO BOX 1430, HARRISONBURG, VA 22803-1430
(540) 564-5800
(833) 552-3026
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
51366
TN
207RG0100X
Gastroenterology Physician
0101266585
VA
207RG0100X
Gastroenterology Physician
Primary
D96613
MD
208M00000X
Hospitalist Physician
51366
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1134480858
—
VA
05
—
267416500
—
MD
01
—
PENDING
BCBST
TN
05
—
PENDING
—
TN
Enumeration date
05/30/2012
Last updated
04/12/2023
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