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NPI Code Detail

MEDICARE: SEMRET TADESSE MEBRAHTU MD

MEDICARE: SEMRET TADESSE MEBRAHTU MD
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
1207R00000XInternal Medicine Physician0101239957VA

General Provider Information

NPI Number : 1609941186
Entity Type Code : Individual
Provider Name (Legal Business Name) : SEMRET TADESSE MEBRAHTU MD
Provider Business Mailing Address
First Line : 984B LASKIN RD
Second Line :
City : VIRGINIA BEACH
State : VA
Zip : 23451-3905
Country : US
Telephone Number : 757-395-6900
Fax Number : 757-425-7180
Provider Business Practice Location Address
First Line : 984B LASKIN RD
Second Line :
City : VIRGINIA BEACH
State : VA
Zip : 23451-3905
Country : US
Telephone Number : 757-395-6900
Fax Number : 757-425-7180
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/21/2006
Last Update Date : 01/16/2024

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