Individual
AGAZI G GEBRESELASSIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
802 LANDMARK DR STE 129, GLEN BURNIE, MD 21061-9121
(410) 602-7782
Mailing address
213 S JEFFERSON ST STE 625, ROANOKE, VA 24011-1713
(540) 224-5516
(540) 224-5684
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
D81171
MD
207RG0100X
Gastroenterology Physician
0101268562
VA
207RG0100X
Gastroenterology Physician
Primary
D81171
MD
Other
Enumeration date
04/12/2013
Last updated
03/09/2022
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