Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0122X | Plastic and Reconstructive Surgery | 44232 | CO |
NPI | 1184648834 |
---|---|
Provider Name | Raffi Gurunian |
First Address | Cleveland, OH 44195-0001 |
Second Address | Cleveland, OH 44195-4507 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/07/2006 |
Last Update Date | 05/07/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
37035061 | (05) | CO |
I50331 | (02) |