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General NPI Number Information
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NPI Number | 1407831795
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Entity Type | Organization
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Legal Business Name | K. HAMAMDJIAN MD PC
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Dates
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Enumeration Date | 12/09/2005
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Last Update Date | 11/30/2011
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Provider Practice Location Address
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Address Line | 27177 LAHSER RD SUITE 104
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City | SOUTHFIELD
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State | MI
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Zip | 48034-4714
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Country | US
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Telephone | 248-353-6580
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Fax | 248-353-0883
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Provider Business Mailing Address
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Address Line | 104 MANORWOOD DR
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City | BLOOMFIELD HILLS
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State | MI
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Zip | 48304-2133
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Country | US
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Telephone | 248-642-1389
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Fax | 248-353-0883
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. KHATCHADOUR WAHAN HAMAMDJIAN
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Credential | MD
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Telephone | 248-642-1389
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 4301037656
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License Number State | MI
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