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General NPI Number Information
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NPI Number | 1073752036
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Entity Type | Individual
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Provider Name | TARIKU DAMTE AYALEW M.D.
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Gender | Male
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Dates
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Enumeration Date | 02/16/2009
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Last Update Date | 12/23/2025
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Provider Practice Location Address
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Address Line | 16000 JOHNSTON MEMORIAL DRIVE
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City | ABINGDON
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State | VA
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Zip | 24211
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Country | US
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Telephone | 301-618-3772
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Fax | 301-618-2986
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Provider Business Mailing Address
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Address Line | 225 SOUTH WHITING STREET APT 605
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City | ALEXANDRIA
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State | VA
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Zip | 22304
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Country | US
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Telephone | 301-618-3772
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Fax | 301-618-2986
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | 0101250064
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | 2013-00134
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License Number State | NC
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Taxonomy #3
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | MD18942
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License Number State | ME
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Taxonomy #4
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | MD2011-0811
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License Number State | NM
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Taxonomy #5
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 0101250064
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License Number State | VA
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Taxonomy #6
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 2013-00134
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License Number State | NC
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Taxonomy #7
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | MD2011-0811
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License Number State | NM
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Taxonomy #8
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | MD18942
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License Number State | ME
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