Provider Demographics
NPI:1477849412
Name:AGONAFER, SENAYET DEREJE (MD)
Entity Type:Individual
Prefix:MS
First Name:SENAYET
Middle Name:DEREJE
Last Name:AGONAFER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:2616 ERWIN RD
Mailing Address - Street 2:UNIT 2224
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27705-3843
Mailing Address - Country:US
Mailing Address - Phone:682-225-0511
Mailing Address - Fax:
Practice Address - Street 1:3001 HANOVER ST
Practice Address - Street 2:DEPARTMENT OF MEDICINE
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21225-1233
Practice Address - Country:US
Practice Address - Phone:410-350-3565
Practice Address - Fax:410-354-0186
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-28
Last Update Date:2016-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
NY2853362085R0202X, 2085B0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No2085B0100XAllopathic & Osteopathic PhysiciansRadiologyBody Imaging