Provider Demographics
NPI:1679830624
Name:AYALEW, HENOCK MARUYE (MD)
Entity Type:Individual
Prefix:DR
First Name:HENOCK
Middle Name:MARUYE
Last Name:AYALEW
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:GEBEYEHU
Other - Middle Name:MARUYE
Other - Last Name:AYALEW
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:500 UNIVERSITY DR
Mailing Address - Street 2:MCH039
Mailing Address - City:HERSHEY
Mailing Address - State:PA
Mailing Address - Zip Code:17033-2360
Mailing Address - Country:US
Mailing Address - Phone:717-531-8903
Mailing Address - Fax:
Practice Address - Street 1:500 UNIVERSITY DR
Practice Address - Street 2:MCH039
Practice Address - City:HERSHEY
Practice Address - State:PA
Practice Address - Zip Code:17033-2360
Practice Address - Country:US
Practice Address - Phone:717-531-8903
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-04-16
Last Update Date:2023-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD454554207R00000X, 208M00000X
PAFA5202065207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine