Agmasie Birhan Woldie, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

15638R Issued in LA

Practice address

510 E Stoner Ave
Shreveport, LA 71101-4243

Phone

(318) 221-8411

Fax

(318) 429-5703

NPI assigned

Aug 9, 2006

Last updated

Jul 3, 2012By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1155081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1341273600000",
    "number": "1255341186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8207 GW SENTELL DR",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711152971",
            "telephone_number": "318-798-5406"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 E STONER AVE",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711014243",
            "telephone_number": "318-221-8411",
            "fax_number": "318-429-5703"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOLDIE",
        "first_name": "AGMASIE",
        "middle_name": "BIRHAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-09",
        "last_updated": "2012-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "LA",
            "license": "15638R",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1467481",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• WKP Arklatex Urology Clinic
• Jennifer Woerner, DMD, MD
• Kenneth Edward Wojcik, D.C.
• Christopher James Wolcott, M.D.
• George M Wolcott, LPC, LMFT, EDD
• Justin Lee Wolfe, DNP, APRN, FNP-BC
• Ryan M Wolfort, MD
• Jordan Kaleb Womack, LPC
• Natoria Womack
• Women's Health Clinic

• Internal Medicine Physician in Shreveport, LA
• Providers in Shreveport, LA by specialty
• Internal Medicine Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.