MEDICARE: SOLOMIE ASMELASH MESGHINA

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	363A00000X	Physician Assistant	0110-002974	VA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	10060907P	OTHER	VA	OPTIMA
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1780824482
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SOLOMIE ASMELASH MESGHINA

Provider Business Mailing Address
First Line	:	PO BOX 7068
Second Line	:
City	:	PORTSMOUTH
State	:	VA
Zip	:	23707-0068
Country	:	US
Telephone Number	:	757-686-3520
Fax Number	:	757-686-0230

Provider Business Practice Location Address
First Line	:	208 E PLUME ST
Second Line	:	STE 213
City	:	NORFOLK
State	:	VA
Zip	:	23510-1757
Country	:	US
Telephone Number	:	757-233-8210
Fax Number	:

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

Provider Enumeration Date	:	02/20/2009
Last Update Date	:	10/08/2010

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