| Provider / Organization | NPI | Date Certified |
|---|---|---|
| ADDISALEM TEDLA | 1134488570 | 2022-11-19 |
Addisalem Tedla is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1134488570. Registration indicates Addisalem Tedla is a provider of services with a specialization in Allopathic & Osteopathic Physicians, Hospitalist (Hospitalist, ) (All Other Specialties & Provider Types, ) (Hospitalist, Allopathic & Osteopathic Physicians) Access to Pediatric Primary Care Providers (Allopathic & Osteopathic Physicians, Pediatrics) (Allopathic & Osteopathic Physicians, Pediatrics) (Pediatrics, ) (Primary Care/Family Planning/APRN/PA, ) (Pediatrics, Allopathic & Osteopathic Physicians)
| Registration | PART-B:Y DME:Y HHA:Y PMD:Y |
| Entity Type | Individual |
| Provider Name | Addisalem Tedla M.D. |
| Practice Office Address | 3300 GALLOWS RD FALLS CHURCH, VA US |
| Practice Office Telephone | 7037766558 |
| Mailing Address | 3300 GALLOWS RD FALLS CHURCH, VA 220423307 US |
| Business Telephone | 7037766558 |
| Address | City / State | Phone / Fax |
|---|---|---|
| 1840 Amherst St | Winchester, VA 226012808 | 5402472940 |
| Direct Messaging Address [] | [email protected] |
| Code | Practice | License No State |
|---|---|---|
| 208M00000X | Allopathic & Osteopathic Physicians Hospitalist Hospitalist All Other Specialties & Provider Types Hospitalist Allopathic & Osteopathic Physicians | 0101258985
VA |
| 208000000X PRIMARY | Access to Pediatric Primary Care Providers Allopathic & Osteopathic Physicians Pediatrics Allopathic & Osteopathic Physicians Pediatrics Pediatrics Primary Care/Family Planning/APRN/PA Pediatrics Allopathic & Osteopathic Physicians | 0101258985
VA |
| 193400000X SING | Group Code |