Provider Demographics
NPI:1982642518
Name:BEYENE, ESKENDER (MD)
Entity Type:Individual
Prefix:DR
First Name:ESKENDER
Middle Name:
Last Name:BEYENE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7033 HIGHLAND MEADOWS CT
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22315-3963
Mailing Address - Country:US
Mailing Address - Phone:202-270-6644
Mailing Address - Fax:703-657-2902
Practice Address - Street 1:1037 STERLING RD
Practice Address - Street 2:SUITE # 102
Practice Address - City:HERNDON
Practice Address - State:VA
Practice Address - Zip Code:20170-3871
Practice Address - Country:US
Practice Address - Phone:202-270-6644
Practice Address - Fax:703-657-2902
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-04
Last Update Date:2014-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101231496207R00000X, 207RC0200X, 207RS0012X, 207RP1001X
DCMD32680207RC0200X
MDD0071312207RS0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep Medicine
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA010102324Medicaid
DC038641300Medicaid
VA010102324Medicaid