Provider Demographics
NPI:1942732789
Name:WORKU, DAWIT KIBRU (MD)
Entity type:Individual
Prefix:
First Name:DAWIT
Middle Name:KIBRU
Last Name:WORKU
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 1:8452 BOSECK DR UNIT 233
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89145-2462
Mailing Address - Country:US
Mailing Address - Phone:240-731-9766
Mailing Address - Fax:
Practice Address - Street 1:29275 W 10 MILE RD
Practice Address - Street 2:
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48336-2817
Practice Address - Country:US
Practice Address - Phone:248-350-0154
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-03-31
Last Update Date:2024-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI70381207R00000X
WI4301502292208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine