Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0100X | Gastroenterologist | 33551 | MA |
NPI | 1003915844 |
---|---|
Provider Name | Mamigon M Garabedian |
First Address | Belmont, MA 02478-3325 |
Second Address | Belmont, MA 02478-3325 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/09/2006 |
Last Update Date | 08/07/2007 |