Individual
MIKIAS WOLDE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
7671 QUARTERFIELD RD STE 200 A AND B, GLEN BURNIE, MD 21061-4998
(443) 351-3376
(410) 582-9155
Mailing address
PO BOX 23329, NEW YORK, NY 10087-3329
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
C0007338
MD
363AS0400X
Surgical Physician Assistant
C0007338
MD
363AS0400X
Surgical Physician Assistant
Primary
—
—
Other
Enumeration date
08/24/2018
Last updated
02/17/2026
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