Healthcare Provider Details

I. General information

NPI: 1578571501
Provider Name (Legal Business Name): MARK Z KARABAJAKIAN DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/04/2006
Last Update Date: 10/26/2021
Certification Date: 10/26/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1435 N MILFORD RD STE 201
MILFORD MI
48381-1015
US

IV. Provider business mailing address

1435 N MILFORD RD STE 201
MILFORD MI
48381-1015
US

V. Phone/Fax

Practice location:
  • Phone: 248-676-8889
  • Fax: 248-685-8039
Mailing address:
  • Phone: 248-305-8707
  • Fax: 248-685-8039

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number5101011367
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code207UN0901X
TaxonomyNuclear Cardiology Physician
License Number220010
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: