Healthcare Provider Details

I. General information

NPI: 1053223784
Provider Name (Legal Business Name): SUNRISE COMPREHENSIVE MEDICAL SVC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/18/2026
Last Update Date: 09/18/2026
Certification Date: 09/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2425 25TH ST SE
WASHINGTON DC
20020-3409
US

IV. Provider business mailing address

10533 PENNYDOG LN
SILVER SPRING MD
20902-4161
US

V. Phone/Fax

Practice location:
  • Phone: 202-889-3600
  • Fax:
Mailing address:
  • Phone: 301-502-6912
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. RUSSOM GHEBRAI
Title or Position: PRESIDENT
Credential: MD
Phone: 301-502-6912