Healthcare Provider Details

I. General information

NPI: 1982837738
Provider Name (Legal Business Name): HAGOP KOJANIAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/27/2009
Last Update Date: 10/23/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 INDUSTRIAL PARK RD SUITE 2.
TAUNTON MA
02780-7395
US

IV. Provider business mailing address

100 INDUSTRIAL PARK RD SUITE 2.
TAUNTON MA
02780-7395
US

V. Phone/Fax

Practice location:
  • Phone: 508-822-2266
  • Fax:
Mailing address:
  • Phone: 508-822-2266
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number254503
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: