Provider Demographics
NPI:1396981361
Name:WUBIE, DAWIT MIHRETIE (MD)
Entity type:Individual
Prefix:
First Name:DAWIT
Middle Name:MIHRETIE
Last Name:WUBIE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1840 AMHERST ST
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:22601-2808
Mailing Address - Country:US
Mailing Address - Phone:540-536-4230
Mailing Address - Fax:540-536-2507
Practice Address - Street 1:1840 AMHERST ST
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:VA
Practice Address - Zip Code:22601-2808
Practice Address - Country:US
Practice Address - Phone:540-536-4230
Practice Address - Fax:540-536-2507
Is Sole Proprietor?:No
Enumeration Date:2008-12-22
Last Update Date:2013-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC150204207R00000X
VA0101246509207R00000X
MDD73365207R00000X
NC2011-01769207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAVV3790AMedicare PIN