Provider Demographics
NPI:1376960625
Name:BEKELE, ZERIHUN (MD)
Entity Type:Individual
Prefix:DR
First Name:ZERIHUN
Middle Name:
Last Name:BEKELE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:ZERIHUN
Other - Middle Name:BEKELE
Other - Last Name:ZERIHUN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:7560 MONARCH MILLS WAY
Mailing Address - Street 2:APT 202
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21046-3318
Mailing Address - Country:US
Mailing Address - Phone:678-327-7873
Mailing Address - Fax:
Practice Address - Street 1:2401 W BELVEDERE AVE
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21215-5216
Practice Address - Country:US
Practice Address - Phone:410-601-9000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-03-25
Last Update Date:2014-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD78267207R00000X, 282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDM83362OtherMD CDS LICENSE