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General NPI Number Information
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NPI Number | 1356460331
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Entity Type | Organization
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Legal Business Name | INTEGRATED MEDICAL CARE AND REHAB.,PC
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Dates
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Enumeration Date | 03/28/2007
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Last Update Date | 04/01/2008
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Provider Practice Location Address
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Address Line | 4600 KING STREET SUITE 4R
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City | ALEXANDRIA
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State | VA
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Zip | 22302
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Country | US
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Telephone | 703-820-8050
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Fax | 703-820-8720
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Provider Business Mailing Address
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Address Line | PO BOX 11529
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City | ALEXANDRIA
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State | VA
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Zip | 22312-0529
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Country | US
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Telephone | 703-820-8050
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Fax | 703-820-8720
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ABRAHAM YIMER ASMAMAW
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Credential | M.D.
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Telephone | 703-820-8050
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2081P2900X
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Taxonomy Name | Pain Medicine (Physical Medicine & Rehabilitation) Physician
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License Number | 0101223994
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | 0101223994
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License Number State | VA
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