| Blue Nile Medical Center Pc | |
|
85 S Bragg St Suite 100 Alexandria VA 22312-2797 | |
| (703) 845-0700 | |
| (703) 794-2269 |
| Full Name | Blue Nile Medical Center Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 85 S Bragg St, Alexandria, Virginia |
| Authorized Official Name and Position | Tedla Anbessie (PHYSICIAN) |
| Authorized Official Contact | 7038450700 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Blue Nile Medical Center Pc 85 S Bragg St Suite 100 Alexandria VA 22312-2797 Ph: (703) 845-0700 | Blue Nile Medical Center Pc 85 S Bragg St Suite 100 Alexandria VA 22312-2797 Ph: (703) 845-0700 |
| NPI Number | 1073544656 |
|---|---|
| Provider Enumeration Date | 07/05/2006 |
| Last Update Date | 12/06/2011 |
| Medicare PECOS PAC ID | 1355304049 |
|---|---|
| Medicare Enrollment ID | O20041120000035 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073544656 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Tedla B Anbessie |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1972590743 PECOS PAC ID: 4183619117 Enrollment ID: I20041120000040 |
| Provider Name | Getachew Y Woldeher |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1073504940 PECOS PAC ID: 0749170975 Enrollment ID: I20050823000396 |
| Provider Name | Yared A Gebreyesus |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1366432692 PECOS PAC ID: 3678504461 Enrollment ID: I20051129000375 |
| Provider Name | Girma K Tefera |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1144429127 PECOS PAC ID: 0749373488 Enrollment ID: I20090610000424 |
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