| Abyssinia Medical Center Llc | |
|
4660 Kenmore Ave Ste 200 Alexandria VA 22304-1306 | |
| (703) 957-9749 | |
| Not Available |
| Full Name | Abyssinia Medical Center Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 4660 Kenmore Ave Ste 200, Alexandria, Virginia |
| Authorized Official Name and Position | Melat Baye (MANAGING DIRECTOR) |
| Authorized Official Contact | 7039447580 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Abyssinia Medical Center Llc 4660 Kenmore Ave Ste 200 Alexandria VA 22304-1306 Ph: (703) 957-9749 | Abyssinia Medical Center Llc 4660 Kenmore Ave Ste 200 Alexandria VA 22304-1306 Ph: (703) 957-9749 |
| NPI Number | 1679199194 |
|---|---|
| Provider Enumeration Date | 06/20/2020 |
| Last Update Date | 02/17/2021 |
| Medicare PECOS PAC ID | 8628489622 |
|---|---|
| Medicare Enrollment ID | O20201124000154 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679199194 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| 207RI0200X | Internal Medicine - Infectious Disease | (* (Not Available)) | Secondary |
| Provider Name | Kurwa Nyigu |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1417925272 PECOS PAC ID: 7416928650 Enrollment ID: I20121107000071 |
| Provider Name | Akeza Teame |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1417155854 PECOS PAC ID: 1456322387 Enrollment ID: I20201124000238 |
| Provider Name | Osman M Ahmedtaha |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1598140105 PECOS PAC ID: 8022307396 Enrollment ID: I20221206000333 |
| Provider Name | Solomon Zerga |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1487159273 PECOS PAC ID: 9830592682 Enrollment ID: I20221207002919 |
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