Provider Demographics
NPI:1467765099
Name:ERQOU, SEBHAT ASNAKE (MD, PHD)
Entity type:Individual
Prefix:DR
First Name:SEBHAT
Middle Name:ASNAKE
Last Name:ERQOU
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2300 FALL HILL AVE STE 317
Mailing Address - Street 2:
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22401-3343
Mailing Address - Country:US
Mailing Address - Phone:540-741-5516
Mailing Address - Fax:540-741-9756
Practice Address - Street 1:1201 SAM PERRY BLVD STE 280
Practice Address - Street 2:
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22401-8400
Practice Address - Country:US
Practice Address - Phone:540-741-5516
Practice Address - Fax:540-741-9756
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-24
Last Update Date:2024-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIMD16235207RC0000X
NY270808282N00000X
VA0101282295207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
RIMD16235OtherLICENSURE
NY270808OtherMEDICAL LICENSE
VA0101282295OtherMEDICAL LICENSE