Provider Demographics
NPI:1841557238
Name:MEDICAL OFFICE OF DR. TEFERA, LLC
Entity Type:Organization
Organization Name:MEDICAL OFFICE OF DR. TEFERA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GIRMA
Authorized Official - Middle Name:
Authorized Official - Last Name:TEFERA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:703-823-4000
Mailing Address - Street 1:9628 SLOWAY COAST DR
Mailing Address - Street 2:
Mailing Address - City:LORTON
Mailing Address - State:VA
Mailing Address - Zip Code:22079-2787
Mailing Address - Country:US
Mailing Address - Phone:703-599-1000
Mailing Address - Fax:
Practice Address - Street 1:50 S PICKETT ST STE 221
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22304-7206
Practice Address - Country:US
Practice Address - Phone:703-823-4000
Practice Address - Fax:855-843-4596
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-23
Last Update Date:2023-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101241655207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty