Provider Demographics
NPI:1255886610
Name:WOLDE, NEWAY GETACHEW
Entity type:Individual
Prefix:DR
First Name:NEWAY
Middle Name:GETACHEW
Last Name:WOLDE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8303 SAND CHERRY LN
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20723-1065
Mailing Address - Country:US
Mailing Address - Phone:301-655-9052
Mailing Address - Fax:
Practice Address - Street 1:9300 LAKESIDE BLVD
Practice Address - Street 2:
Practice Address - City:OWINGS MILLS
Practice Address - State:MD
Practice Address - Zip Code:21117-4953
Practice Address - Country:US
Practice Address - Phone:410-363-8066
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-16
Last Update Date:2021-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD24165183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist