Provider Demographics
NPI:1518065374
Name:MEKONNEN, DAWIT GIRMA (MD)
Entity type:Individual
Prefix:DR
First Name:DAWIT
Middle Name:GIRMA
Last Name:MEKONNEN
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 1:9300 DEWITT LOOP
Mailing Address - Street 2:HOSPITALIST SERVICE 7TH FLOOR OAK PAVILION
Mailing Address - City:FORT BELVOIR
Mailing Address - State:VA
Mailing Address - Zip Code:22060-5285
Mailing Address - Country:US
Mailing Address - Phone:703-599-9540
Mailing Address - Fax:
Practice Address - Street 1:9300 DEWITT LOOP
Practice Address - Street 2:HOSPITALIST SERVICE 7TH FLOOR OAK PAVILION
Practice Address - City:FORT BELVOIR
Practice Address - State:VA
Practice Address - Zip Code:22060-5285
Practice Address - Country:US
Practice Address - Phone:703-599-9540
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2022-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101234596207R00000X, 208M00000X
MDD0061307208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
DCJ0950009OtherBCBS
DC037300700Medicaid
MD405433400Medicaid
MD64208402OtherBCBS
MD64208402OtherBCBS
018506C82Medicare ID - Type Unspecified