Individual
CANAAN MEKONNEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
15215 SHADY GROVE RD STE 100, ROCKVILLE, MD 20850-3235
(240) 506-0530
Mailing address
15215 SHADY GROVE RD STE 100, ROCKVILLE, MD 20850-3235
(240) 506-0530
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
C0007774
MD
363A00000X
Physician Assistant
Primary
PA67008
CA
Other
Enumeration date
01/01/2021
Last updated
09/30/2025
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