Individual
BIRUK TAFFESSE AMARE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
827 LINDEN AVE, BALTIMORE, MD 21201-4606
(410) 225-8000
Mailing address
PO BOX 64442, BALTIMORE, MD 21264-4442
(410) 225-8000
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
D77817
MD
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
422737900
—
MD
01
—
S062-0541
CAREFIRST BC/BS
MD
Enumeration date
01/21/2014
Last updated
11/19/2021
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