Individual
DR. DEREJE LEGESSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
8109 HINSON FARM ROAD, #504, ALEXANDRIA, VA 22306-3427
(703) 787-0280
(703) 778-0046
Mailing address
2101 E JEFFERSON ST, ROCKVILLE, MD 20852-4908
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
0101235106
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010157234
—
VA
05
—
1538150339
—
VA
01
—
P00228902
RR MEDICARE
—
Enumeration date
10/31/2005
Last updated
06/17/2021
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