Healthcare Provider Details

I. General information

NPI: 1215677331
Provider Name (Legal Business Name): TESFAYE SOLOMON MOGES MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/29/2022
Last Update Date: 01/20/2026
Certification Date: 01/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

901 HARRY S TRUMAN DR N
LARGO MD
20774-5477
US

IV. Provider business mailing address

2010 HEALTH CAMPUS DR
ROCKINGHAM VA
22801-8679
US

V. Phone/Fax

Practice location:
  • Phone: 240-667-0225
  • Fax:
Mailing address:
  • Phone: 540-689-1110
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number0101286198
License Number StateVA
# 3
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number0101286198
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: