Provider Demographics
NPI:1720238868
Name:AYELE, PETROS ASSEFA (MD INTERNAL MED)
Entity Type:Individual
Prefix:
First Name:PETROS
Middle Name:ASSEFA
Last Name:AYELE
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Gender:M
Credentials:MD INTERNAL MED
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Other - Credentials:
Mailing Address - Street 1:85 S. BRAGG STREET SUITE #100
Mailing Address - Street 2:BLUE NILE MEDICAL CENTER
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22312
Mailing Address - Country:US
Mailing Address - Phone:703-845-0700
Mailing Address - Fax:703-794-2269
Practice Address - Street 1:2712 JEFFERSON DAVIS HIGHWAY
Practice Address - Street 2:SUITE 101
Practice Address - City:STAFFORD
Practice Address - State:VA
Practice Address - Zip Code:22554
Practice Address - Country:US
Practice Address - Phone:540-657-9191
Practice Address - Fax:540-657-0986
Is Sole Proprietor?:No
Enumeration Date:2008-09-25
Last Update Date:2008-09-25
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Provider Licenses
StateLicense IDTaxonomies
VA0101242641207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine