Organization
NEW FLOWER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MELAKU AYALEW M.D. (CEO)
(703) 200-5422
Entity
Organization
Contact information
Practice address
50 SOUTH PICKETT ST, ALEXANDRIA, VA 22304
(703) 370-2300
Mailing address
8439 LAKE MIST WAY, FAIRFAX STATION, VA 22039-2676
(703) 646-5500
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
0101055711
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0101055711
DEPARTMENT OF HEALTH PROFESSIONS
VA
01
—
D0052560
MARYLAND BOARD OF PHYSCIANS
MD
Enumeration date
12/01/2009
Last updated
12/01/2009
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