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General NPI Number Information
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NPI Number | 1275394074
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Entity Type | Organization
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Legal Business Name | YMPHYSICIAN CARE SERVICES LLC
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Dates
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Enumeration Date | 01/18/2024
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Last Update Date | 01/18/2024
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Provider Practice Location Address
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Address Line | 300 PARK HILL DR
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City | FREDERICKSBURG
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State | VA
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Zip | 22401-3387
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Country | US
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Telephone | 540-522-6101
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Fax |
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Provider Business Mailing Address
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Address Line | 5786 COACHVIEW CT
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City | HAYMARKET
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State | VA
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Zip | 20169-3207
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Country | US
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Telephone | 540-522-6101
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | YEMISRACH MULUGETA
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Credential | MD
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Telephone | 540-522-6101
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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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