Provider Demographics
NPI:1063974061
Name:AKPAN, EYERUSALEM BERHANU (MD)
Entity type:Individual
Prefix:DR
First Name:EYERUSALEM
Middle Name:BERHANU
Last Name:AKPAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:EYERUSALEM
Other - Middle Name:BERHANU
Other - Last Name:TEKLEMARIAM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:6354 WALKER LN STE 400
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22310-3252
Mailing Address - Country:US
Mailing Address - Phone:505-272-4661
Mailing Address - Fax:505-272-4628
Practice Address - Street 1:6354 WALKER LN STE 400
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22310-3252
Practice Address - Country:US
Practice Address - Phone:571-472-7234
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-01
Last Update Date:2024-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101282408207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine