Provider Demographics
NPI:1558508184
Name:RAHEL G. YIRGA MD PC
Entity Type:Organization
Organization Name:RAHEL G. YIRGA MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RAHEL
Authorized Official - Middle Name:G
Authorized Official - Last Name:YIRGA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:800-969-1104
Mailing Address - Street 1:2833 CLEAVE DR
Mailing Address - Street 2:
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22042-2307
Mailing Address - Country:US
Mailing Address - Phone:703-509-6029
Mailing Address - Fax:703-532-4073
Practice Address - Street 1:20 PIDGEON HILL DR
Practice Address - Street 2:
Practice Address - City:STERLING
Practice Address - State:VA
Practice Address - Zip Code:20165-6154
Practice Address - Country:US
Practice Address - Phone:800-969-1104
Practice Address - Fax:703-763-7272
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-20
Last Update Date:2023-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101233758207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1558508184Medicaid
WV3810014162Medicaid
VA1558508184Medicaid