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1346436276

NPI Code Detail

MEDICARE: ERMIAS AYTENFISU MEKONNEN M.D.

MEDICARE: ERMIAS AYTENFISU MEKONNEN M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084N0400X	Neurology Physician	9374505-1205	UT
2	2084N0400X	Neurology Physician	0101256170	VA
3	2084N0400X	Neurology Physician	D0086800	MD
4	2084N0400X	Neurology Physician	2025013771	MO
5	2084N0400X	Neurology Physician	104198	GA
6	2084N0400X	Neurology Physician	1471653	ID
7	208M00000X	Hospitalist Physician	T2216	TX
8	2084N0400X	Neurology Physician	MD040014	DC

General Provider Information

NPI Number	:	1346436276
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ERMIAS AYTENFISU MEKONNEN M.D.

Provider Business Mailing Address
First Line	:	2041 GEORGIA AVE NW STE 6101
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20060-0001
Country	:	US
Telephone Number	:	202-865-6679
Fax Number	:

Provider Business Practice Location Address
First Line	:	8600 OLD GEORGETOWN RD
Second Line	:
City	:	BETHESDA
State	:	MD
Zip	:	20814-1497
Country	:	US
Telephone Number	:	301-896-3100
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/25/2007
Last Update Date	:	07/24/2025

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Directions to “ ERMIAS AYTENFISU MEKONNEN M.D.” Practice Location

Language	Start Address	Practice Location

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