Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | MT204528 | PA |
Y | 207QA0505X | Family Doctor - Adult Medicine | MD044596 | DC |
NPI | 1235576828 |
---|---|
Provider Name | Gelane Gemechisa |
First Address | Washington, DC 20006-2107 |
Second Address | Washington, DC 20006-2107 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/05/2013 |
Last Update Date | 03/01/2022 |