Provider Demographics
NPI:1467430215
Name:YOHANNES, DAWIT (MD)
Entity Type:Individual
Prefix:DR
First Name:DAWIT
Middle Name:
Last Name:YOHANNES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12905 CRICKMORE TRCE
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20720-4683
Mailing Address - Country:US
Mailing Address - Phone:202-865-4203
Mailing Address - Fax:202-865-3338
Practice Address - Street 1:2041 GEORGIA AVE NW
Practice Address - Street 2:SUITE 2322
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20060-0001
Practice Address - Country:US
Practice Address - Phone:202-865-4203
Practice Address - Fax:202-865-3338
Is Sole Proprietor?:No
Enumeration Date:2006-01-03
Last Update Date:2008-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0059681207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC011599M58Medicare PIN
DC491690Medicare PIN
MDH83615Medicare UPIN