| Selam Medical Service Llc | |
|
1328 Southern Ave Se Suite 205 Washington DC 20032-4689 | |
| (202) 544-7744 | |
| Not Available |
| Full Name | Selam Medical Service Llc |
|---|---|
| Speciality | Internal Medicine - Adolescent Medicine |
| Location | 1328 Southern Ave Se, Washington, District Of Columbia |
| Authorized Official Name and Position | Russom Bariaghaber Ghebrai (SOLE MBR) |
| Authorized Official Contact | 3015026912 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Selam Medical Service Llc 603 Sligo Ave Apt 313 Silver Spring MD 20910-4765 Ph: (301) 588-0724 | Selam Medical Service Llc 1328 Southern Ave Se Suite 205 Washington DC 20032-4689 Ph: (202) 544-7744 |
| NPI Number | 1982930517 |
|---|---|
| Provider Enumeration Date | 11/02/2009 |
| Last Update Date | 11/02/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982930517 | NPI | - | NPPES |
| 059550700 | Medicaid | DC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RA0000X | Internal Medicine - Adolescent Medicine | MD035237 (District Of Columbia) | Primary |
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