Dura Internal Medicine Limited Liability Company | |
15225 Shady Grove Rd Ste 103 Rockville MD 20850-3252 | |
(240) 778-4411 | |
Not Available |
Full Name | Dura Internal Medicine Limited Liability Company |
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Speciality | Internal Medicine |
Location | 15225 Shady Grove Rd Ste 103, Rockville, Maryland |
Authorized Official Name and Position | Fisehatsion G Mehari (OWNER/PHYSICIAN) |
Authorized Official Contact | 2407784411 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Dura Internal Medicine Limited Liability Company 2315 Henslowe Dr Potomac MD 20854-2951 Ph: (240) 778-4411 | Dura Internal Medicine Limited Liability Company 15225 Shady Grove Rd Ste 103 Rockville MD 20850-3252 Ph: (240) 778-4411 |
NPI Number | 1134742695 |
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Provider Enumeration Date | 05/19/2020 |
Last Update Date | 05/19/2020 |
Medicare PECOS PAC ID | 7214359231 |
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Medicare Enrollment ID | O20200622000571 |
Identifier | Type | State | Issuer |
---|---|---|---|
1134742695 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | (* (Not Available)) | Primary |
Provider Name | Fisehatsion G Mehari |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1023052867 PECOS PAC ID: 4688677107 Enrollment ID: I20060822000454 |
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