Individual
MR. GEBREMEDHIN YOHANNES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
0101222995
VA
207R00000X
Internal Medicine Physician
Primary
D55475
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010222265
—
VA
01
—
184410
BCBS ANTHEM
VA
01
—
496675
MDIPA OPTIMUM CHOICE
VA
01
—
8505
KAISER PERMANENTE
VA
Enumeration date
06/04/2006
Last updated
12/29/2021
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