Provider Demographics
NPI:1174370035
Name:HUNDITO, BINYAM
Entity type:Individual
Prefix:
First Name:BINYAM
Middle Name:
Last Name:HUNDITO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:41 ELLSWORTH HEIGHTS ST
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20910-4314
Mailing Address - Country:US
Mailing Address - Phone:240-478-4195
Mailing Address - Fax:
Practice Address - Street 1:41 ELLSWORTH HEIGHTS ST
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20910-4314
Practice Address - Country:US
Practice Address - Phone:240-478-4195
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-30
Last Update Date:2024-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171000000XOther Service ProvidersMilitary Health Care Provider