Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207SG0201X | Clinical Genetics (M.D.) | 35.120140 | OH |
N | 207SG0201X | Clinical Genetics (M.D.) | 4301089374 | MI |
N | 208000000X | Pediatrician | 35.120140 | OH |
N | 208000000X | Pediatrician | 4301089374 | MI |
N | 208000000X | Pediatrician | MD431070 | PA |
NPI | 1710197181 |
---|---|
Provider Name | Dr. Jirair Krikor Bedoyan |
First Address | Euclid, OH 44117-1714 |
Second Address | Cleveland, OH 44106-1716 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/05/2007 |
Last Update Date | 17/12/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
35.120140 | LICENSE (01) | OH |