Provider Demographics
NPI:1518080993
Name:TESEMMA, NEGASH (DO)
Entity Type:Individual
Prefix:DR
First Name:NEGASH
Middle Name:
Last Name:TESEMMA
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12701 RUXTON RD
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20904-5275
Mailing Address - Country:US
Mailing Address - Phone:301-384-3274
Mailing Address - Fax:
Practice Address - Street 1:1901 D ST SE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20003-2534
Practice Address - Country:US
Practice Address - Phone:202-698-0422
Practice Address - Fax:202-673-8010
Is Sole Proprietor?:No
Enumeration Date:2007-04-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCDO32081207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine