Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2080P0202X | Pediatric Cardiologist | M-8823 | ID |
Y | 2080P0202X | Pediatric Cardiologist | MD00039312 | WA |
NPI | 1083666127 |
---|---|
Provider Name | Carl Puzant Garabedian |
First Address | Liberty Lake, WA 99019-0421 |
Second Address | Spokane, WA 99204-2307 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/05/2006 |
Last Update Date | 01/10/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000568 | (05) | OR |
0149942 | (05) | MT |
806205300 | (05) | ID |
8280570 | (05) | WA |
H53170 | (02) | WA |