Provider Demographics
NPI:1982649034
Name:ZEWDU, WORKU B (MD)
Entity Type:Individual
Prefix:
First Name:WORKU
Middle Name:B
Last Name:ZEWDU
Suffix:
Gender:M
Credentials:MD
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Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:100 W KINGSBRIDGE RD
Mailing Address - Street 2:MEDICAL DEPT
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10468-3961
Mailing Address - Country:US
Mailing Address - Phone:718-410-1436
Mailing Address - Fax:718-579-1192
Practice Address - Street 1:100 W KINGSBRIDGE RD
Practice Address - Street 2:MEDICAL DEPT
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10468-3961
Practice Address - Country:US
Practice Address - Phone:718-410-1436
Practice Address - Fax:718-579-1192
Is Sole Proprietor?:No
Enumeration Date:2006-06-20
Last Update Date:2014-12-02
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY216820204C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204C00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine, Sports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYH32733Medicare UPIN