Individual
DR. ASHENAFI WAKTOLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
8115 FENTON ST, SUITE 209, SILVER SPRING, MD 20910-4700
(301) 920-0721
Mailing address
911 LANGLEY DR, SILVER SPRING, MD 20901-3734
(301) 920-0721
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
D0052706
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036175700
—
DC
05
—
540310300
—
MD
01
—
8137444
UNITED HEALTH CARE
—
01
—
K8290001
CARE FIRST BLUE CROSS BLUE SHIELD
—
Enumeration date
07/02/2006
Last updated
01/05/2013
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