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Selamawit Woldekidan Woldemariam

Internal Medicine

Allopathic & Osteopathic Physicians

PECOS Enrollment

This provider is enrolled in PECOS as SELAMAWIT WOLDEMARIAM.

Based on the most recent information from CMS, provider Selamawit Woldekidan Woldemariam is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 5 days ago.

Profile Details

Provider ID
1164881975
Provider Type
Individual
Full Name
Woldemariam, Selamawit Woldekidan
Title
Dr.
Credential
M.D.

Gender
Female
Sole Proprietor
No
Enumeration Date
2/22/2016
Last Updated
8/15/2019

Contact Information

Practice Location

743 Spring St NE, Gainesville, GA 30501

(770) 219-9000

Unlisted Fax

Mailing Location

PO Box 742616, Atlanta, GA 30374-2616

(770) 219-8420

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 207R00000X Primary	Description Internal Medicine Allopathic & Osteopathic Physicians	License 83808 Georgia
Code 207R00000X	Description Internal Medicine Allopathic & Osteopathic Physicians	License MT210107 Pennsylvania

Selamawit Woldekidan Woldemariam

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

Patel, Gopi

Penrose, O'Connell Caleb

Javellana, Eileen

Chris Recknor, M.D. Pc

Parks, James Frederick

Oberman, Robert

Al Azmeh, Ghalia

Sumner, Sean M

Patel, Pratikkumar

Sherif, Hamdi Younis