Provider Demographics
NPI:1528226719
Name:DESALEW, TADELE WORKU (MD)
Entity Type:Individual
Prefix:DR
First Name:TADELE
Middle Name:WORKU
Last Name:DESALEW
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 1:640 S STATE ST, MAIL CODE 3055
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:DE
Mailing Address - Zip Code:19901
Mailing Address - Country:US
Mailing Address - Phone:302-480-1688
Mailing Address - Fax:302-480-9807
Practice Address - Street 1:1058 S GOVERNORS AVE
Practice Address - Street 2:SUITE 101
Practice Address - City:DOVER
Practice Address - State:DE
Practice Address - Zip Code:19904-6920
Practice Address - Country:US
Practice Address - Phone:302-401-1500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-25
Last Update Date:2019-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC1-0010574207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism