Healthcare Provider Details
I. General information
NPI: 1043289549
Provider Name (Legal Business Name): NESHAN V OHANIAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 03/16/2006
Last Update Date: 12/15/2011
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1719 W BIG BEAVER RD
TROY MI
48084-3510
US
IV. Provider business mailing address
3601 W 13 MILE RD ANESTHESIOLOGY DEPT
ROYAL OAK MI
48073
US
V. Phone/Fax
- Phone: 248-458-0400
- Fax: 248-458-0310
- Phone: 248-458-0400
- Fax: 248-458-0310
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207L00000X |
| Taxonomy | Anesthesiology Physician |
| License Number | 4301044970 |
| License Number State | MI |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: