Provider Demographics
NPI:1851119721
Name:TRANSATLANTIC MEDICAL ASSOCIATES
Entity type:Organization
Organization Name:TRANSATLANTIC MEDICAL ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:YARED
Authorized Official - Middle Name:W
Authorized Official - Last Name:ENDAILALU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:651-399-7812
Mailing Address - Street 1:8401 WHITEHEVEN CT
Mailing Address - Street 2:
Mailing Address - City:LORTON
Mailing Address - State:VA
Mailing Address - Zip Code:22079
Mailing Address - Country:US
Mailing Address - Phone:571-457-2115
Mailing Address - Fax:281-572-8428
Practice Address - Street 1:5724 EDSALL RD SUITE B
Practice Address - Street 2:
Practice Address - City:ALEXANDERIA
Practice Address - State:VA
Practice Address - Zip Code:22304
Practice Address - Country:US
Practice Address - Phone:571-457-2115
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-30
Last Update Date:2024-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care