Provider Demographics
NPI:1275394074
Name:YMPHYSICIAN CARE SERVICES LLC
Entity Type:Organization
Organization Name:YMPHYSICIAN CARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:YEMISRACH
Authorized Official - Middle Name:
Authorized Official - Last Name:MULUGETA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:540-522-6101
Mailing Address - Street 1:5786 COACHVIEW CT
Mailing Address - Street 2:
Mailing Address - City:HAYMARKET
Mailing Address - State:VA
Mailing Address - Zip Code:20169-3207
Mailing Address - Country:US
Mailing Address - Phone:540-522-6101
Mailing Address - Fax:
Practice Address - Street 1:300 PARK HILL DR
Practice Address - Street 2:
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22401-3387
Practice Address - Country:US
Practice Address - Phone:540-522-6101
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-18
Last Update Date:2024-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty