Individual
ASHEBIR GEBRU WOLDEABEZGI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
11637 TERRACE DR, SUITE 103, WALDORF, MD 20602-3706
(301) 374-9725
(301) 374-9181
Mailing address
11637 TERRACE DR, SUITE 103, WALDORF, MD 20602-3706
(301) 374-9725
(301) 374-9181
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
0101240403
VA
207R00000X
Internal Medicine Physician
D0062596
MD
207R00000X
Internal Medicine Physician
MD035472
DC
207RI0200X
Infectious Disease Physician
0101240403
VA
207RI0200X
Infectious Disease Physician
D0062596
MD
207RI0200X
Infectious Disease Physician
Primary
MD035472
DC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010347505
—
VA
01
—
010874247
CIGNA
—
01
—
1419486
AETNA HMO
—
01
—
207251
JOHNS HOPKINS MED SERVICE
—
01
—
2152946
MAMSI LIFE AND HEALTH
—
01
—
2159246
MDIPA
—
01
—
248272
ANTHEM
VA
01
—
265824
KAISER PERMANENTE
—
01
—
313733
AMERIGROUP
—
05
—
412412000
—
MD
01
—
4124120000
MARYLAN PHYSICAN CARE
MD
01
—
6023
BRAVO
—
01
—
70310001
BLUE CROSS BLUE SHIELD
—
01
—
7223718
AETNA
—
01
—
89335301
BCBS OF MARYLAND CAREFIRS
MD
01
—
P00414839
MEDICARE RAILROAD
—
Enumeration date
07/01/2006
Last updated
10/10/2014
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