Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207P00000X | Emergency Physician | OS8081 | FL |
Y | 208D00000X | General Practice Physician | OS8081 | FL |
NPI | 1013963974 |
---|---|
Provider Name | George Kamajian |
First Address | Largo, FL 33771-3544 |
Second Address | Largo, FL 33771-3544 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/05/2006 |
Last Update Date | 11/05/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
B98979 | (02) |