Provider Demographics
NPI:1255599239
Name:TETEMKE, TESFAYE (MD)
Entity type:Individual
Prefix:
First Name:TESFAYE
Middle Name:
Last Name:TETEMKE
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 1:6005 WALHAVEN DR
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22310-2621
Mailing Address - Country:US
Mailing Address - Phone:571-777-8494
Mailing Address - Fax:571-777-8493
Practice Address - Street 1:5276 DAWES AVE
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22311-1404
Practice Address - Country:US
Practice Address - Phone:571-777-8494
Practice Address - Fax:571-777-8493
Is Sole Proprietor?:No
Enumeration Date:2008-05-27
Last Update Date:2024-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0069109208M00000X
VA0101244617207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist