Provider Demographics
NPI:1003020439
Name:SISAY, YONAS (MD)
Entity Type:Individual
Prefix:DR
First Name:YONAS
Middle Name:
Last Name:SISAY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5375 DUKE ST
Mailing Address - Street 2:# 704
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22304-3075
Mailing Address - Country:US
Mailing Address - Phone:703-981-3717
Mailing Address - Fax:
Practice Address - Street 1:822 GUILFORD AVE
Practice Address - Street 2:#100
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21202-3707
Practice Address - Country:US
Practice Address - Phone:410-385-9672
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0057228207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine