Provider Demographics
NPI:1548600281
Name:WOLDEMICHAEL, JOBIRA ANBESSIE (MD)
Entity Type:Individual
Prefix:DR
First Name:JOBIRA
Middle Name:ANBESSIE
Last Name:WOLDEMICHAEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:MEDICAL CENTER BLVD
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27157-0001
Mailing Address - Country:US
Mailing Address - Phone:336-716-4650
Mailing Address - Fax:336-716-4318
Practice Address - Street 1:MEDICAL CENTER BLVD
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27157-1212
Practice Address - Country:US
Practice Address - Phone:336-716-4650
Practice Address - Fax:336-716-4318
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-26
Last Update Date:2021-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA006554207R00000X
NC2021-01426207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine