MEDICARE: DR. MESSAY ADDIS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	0202214490	VA
2	183500000X	Pharmacist	PH100002343	DC
3	183500000X	Pharmacist	23972	MD
4	183500000X	Pharmacist	PTS022000	LA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1922525724
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MESSAY ADDIS

Provider Business Mailing Address
First Line	:	1001 W BRADDOCK RD
Second Line	:
City	:	ALEXANDRIA
State	:	VA
Zip	:	22302-3229
Country	:	US
Telephone Number	:	703-371-8512
Fax Number	:

Provider Business Practice Location Address
First Line	:	3700 NEWARK ST NW
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20016-3036
Country	:	US
Telephone Number	:	202-966-0320
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/23/2017
Last Update Date	:	02/13/2025

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