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General NPI Number Information
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NPI Number | 1053223784
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Entity Type | Organization
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Legal Business Name | SUNRISE COMPREHENSIVE MEDICAL SVC
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Dates
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Enumeration Date | 09/18/2026
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Last Update Date | 09/18/2026
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Provider Practice Location Address
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Address Line | 2425 25TH ST SE
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City | WASHINGTON
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State | DC
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Zip | 20020-3409
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Country | US
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Telephone | 202-889-3600
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Fax |
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Provider Business Mailing Address
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Address Line | 10533 PENNYDOG LN
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City | SILVER SPRING
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State | MD
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Zip | 20902-4161
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Country | US
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Telephone | 301-502-6912
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. RUSSOM GHEBRAI
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Credential | MD
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Telephone | 301-502-6912
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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