| Doctor Name: | DR. GENET DESTA |
| NPI Number: | 1740301761 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MD |
| License Number: | MD |
| Business Practice Address: | 1901 D St Se Washington, DC - 200032534 |
| Business Phone Number: | 2026980438 |
| Business Fax Number: | 2026738010 |
| Mailing Address: | 5268 Cozy Glen Ln, ALEXANDRIA |
| State: | VA |
| Postal Code: | 223123900 |
| Phone Number: | 7032127477 |
| Fax Number: | 2026738010 |
| NPI Enumeration Date: | 04/03/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | MD |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | DC |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |