Basic Information
| Provider Information | |||||||||
| NPI: | 1891204038 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GEBEYEHU | ||||||||
| FirstName: | AMLAKIE | ||||||||
| MiddleName: | DIGAFIE | ||||||||
| NamePrefix: | MR. | ||||||||
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| Credential: | DNP, CRNA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 10901 CHERRYVALE CT | ||||||||
| Address2: | |||||||||
| City: | BELTSVILLE | ||||||||
| State: | MD | ||||||||
| PostalCode: | 207053835 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3012379525 | ||||||||
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| Practice Location | |||||||||
| Address1: | 900 S CATON AVE | ||||||||
| Address2: | |||||||||
| City: | BALTIMORE | ||||||||
| State: | MD | ||||||||
| PostalCode: | 212295201 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6672346000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/20/2017 | ||||||||
| LastUpdateDate: | 09/20/2017 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 367500000X | R191567 | MD | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Anesthetist, Certified Registered |
No ID Information.