Provider Demographics
NPI:1619900149
Name:GEBREWOLD, HIRUT ABEBE (MD)
Entity Type:Individual
Prefix:DR
First Name:HIRUT
Middle Name:ABEBE
Last Name:GEBREWOLD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:109 GOVERNORS CT
Mailing Address - Street 2:#G
Mailing Address - City:GLEN BURNIE
Mailing Address - State:MD
Mailing Address - Zip Code:21061-1867
Mailing Address - Country:US
Mailing Address - Phone:410-609-0764
Mailing Address - Fax:
Practice Address - Street 1:109 GOVERNORS CT
Practice Address - Street 2:#G
Practice Address - City:GLEN BURNIE
Practice Address - State:MD
Practice Address - Zip Code:21061-1867
Practice Address - Country:US
Practice Address - Phone:410-609-0764
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-08
Last Update Date:2022-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0064745207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine