Provider Demographics
NPI:1093965584
Name:MAHETEME BAYEH
Entity Type:Organization
Organization Name:MAHETEME BAYEH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:MAHETEME
Authorized Official - Middle Name:
Authorized Official - Last Name:BAYEH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:240-997-1680
Mailing Address - Street 1:9801 GREENBELT RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:LANHAM
Mailing Address - State:MD
Mailing Address - Zip Code:20706-2273
Mailing Address - Country:US
Mailing Address - Phone:301-552-6666
Mailing Address - Fax:301-552-6216
Practice Address - Street 1:9801 GREENBELT RD
Practice Address - Street 2:SUITE 101
Practice Address - City:LANHAM
Practice Address - State:MD
Practice Address - Zip Code:20706-2273
Practice Address - Country:US
Practice Address - Phone:301-552-6666
Practice Address - Fax:301-552-6216
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-22
Last Update Date:2008-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDDO54579207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC0759OtherCAREFIRST BLUE CROSS BLUE SHIELD
MD57100100Medicaid
69392OtherAMERIGROUP
DC492252Medicare PIN
MD57100100Medicaid