Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208100000X | Physical Medicine & Rehabilitation Doctor | 5101014141 | MI |
N | 2081P2900X | Pain Medicine | 5101014141 | MI |
NPI | 1194807099 |
---|---|
Provider Name | John A Yarjanian |
First Address | Ann Arbor, MI 48108-1633 |
Second Address | Ann Arbor, MI 48108-3364 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/10/2006 |
Last Update Date | 19/10/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
4779633 | (05) | MI |
I41589 | (02) | MI |