| Organization Name: | PETROS ASSEFA AYELE |
| NPI Number: | 1306188495 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | PETROS AYELE (PHYSICIAN) |
| Mailing Address: | 17601 Harpers Ferry Dr Dumfries |
| State: | VA US |
| Postal Code: | 220252029 |
| Phone Number: | 7036590651 |
| Fax Number: | |
| NPI Enumeration Date: | 03/26/2013 |
| NPI Last Update Date: | 03/26/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QP2300X |
| License Number: | 0101242641 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | VA |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Primary Care |
| Taxonomy Definition: | |