Provider Demographics
NPI:1235576828
Name:GEMECHISA, MD, GELANE (MD)
Entity type:Individual
Prefix:
First Name:GELANE
Middle Name:
Last Name:GEMECHISA, MD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8000 TOWERS CRESCENT DR STE 1376
Mailing Address - Street 2:
Mailing Address - City:VIENNA
Mailing Address - State:VA
Mailing Address - Zip Code:22182-6207
Mailing Address - Country:US
Mailing Address - Phone:202-240-8504
Mailing Address - Fax:202-998-9396
Practice Address - Street 1:8000 TOWERS CRESCENT DR STE 1376
Practice Address - Street 2:
Practice Address - City:TYSONS CORNER
Practice Address - State:VA
Practice Address - Zip Code:22182-6207
Practice Address - Country:US
Practice Address - Phone:202-240-8504
Practice Address - Fax:202-998-9396
Is Sole Proprietor?:No
Enumeration Date:2013-05-23
Last Update Date:2025-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMT204528207Q00000X
DCMD044596202D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes202D00000XAllopathic & Osteopathic PhysiciansIntegrative Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine