MEDICARE: DR. SHIMELLIS ALEMAYEHU 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
1	2084N0400X	Neurology Physician	D40535	MD
2	2084S0012X	Sleep Medicine (Psychiatry & Neurology) Physician	D40535	MD

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	643148ZEZA	OTHER	DC	MEDICARE PTAN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1790883288
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SHIMELLIS ALEMAYEHU MD

Provider Business Mailing Address
First Line	:	9841 GREENBELT RD STE 206
Second Line	:
City	:	LANHAM
State	:	MD
Zip	:	20706-6270
Country	:	US
Telephone Number	:	301-552-0008
Fax Number	:	301-552-2066

Provider Business Practice Location Address
First Line	:	9841 GREENBELT RD STE 206
Second Line	:
City	:	LANHAM
State	:	MD
Zip	:	20706-6270
Country	:	US
Telephone Number	:	301-552-0008
Fax Number	:	301-552-2066

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

Provider Enumeration Date	:	09/20/2006
Last Update Date	:	03/02/2026

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Directions to “ DR. SHIMELLIS ALEMAYEHU MD” Practice Location

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