Provider Demographics
NPI:1073045969
Name:WHITFIELD, SELAMAWIT ADMASU (MD)
Entity Type:Individual
Prefix:DR
First Name:SELAMAWIT
Middle Name:ADMASU
Last Name:WHITFIELD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:SELAMAWIT
Other - Middle Name:
Other - Last Name:ADMASU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:668 BERRY LN
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40502-2244
Mailing Address - Country:US
Mailing Address - Phone:513-708-8518
Mailing Address - Fax:
Practice Address - Street 1:3201 MATLOCK RD STE 210
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76015-2946
Practice Address - Country:US
Practice Address - Phone:817-468-4689
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-03-30
Last Update Date:2022-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA390200000X
TXT3410207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program