Provider Demographics
NPI:1114130937
Name:TESSEMA, ISAIAS G (MD)
Entity Type:Individual
Prefix:DR
First Name:ISAIAS
Middle Name:G
Last Name:TESSEMA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:951 SETON DR APT 5
Mailing Address - Street 2:
Mailing Address - City:CUMBERLAND
Mailing Address - State:MD
Mailing Address - Zip Code:21502-1846
Mailing Address - Country:US
Mailing Address - Phone:301-722-4278
Mailing Address - Fax:301-729-9260
Practice Address - Street 1:13800 MCMULLEN HWY SW
Practice Address - Street 2:
Practice Address - City:CUMBERLAND
Practice Address - State:MD
Practice Address - Zip Code:21502-5622
Practice Address - Country:US
Practice Address - Phone:301-729-7115
Practice Address - Fax:301-729-9260
Is Sole Proprietor?:No
Enumeration Date:2007-05-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDD0055881207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine