Healthcare Provider Details

I. General information

NPI: 1437121910
Provider Name (Legal Business Name): RAHEL G YIRGA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/07/2006
Last Update Date: 12/07/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20 PIDGEON HILL DR STE 208
STERLING VA
20165-6134
US

IV. Provider business mailing address

2418 W INDIAN TRL STE F
AURORA IL
60506-1590
US

V. Phone/Fax

Practice location:
  • Phone: 703-539-6029
  • Fax: 703-757-1712
Mailing address:
  • Phone: 630-907-0578
  • Fax: 630-907-9015

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number0101233758
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: