Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204C00000X | Sports Medicine Doctor | 0101260753 | VA |
NPI | 1134414667 |
---|---|
Provider Name | Dr. Frehiwot Derbew Temesgen |
First Address | Gainesville, VA 20155-3400 |
Second Address | Fredericksburg, VA 22401-4466 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/06/2011 |
Last Update Date | 04/01/2022 |