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General NPI Number Information
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NPI Number | 1487846804
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Entity Type | Organization
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Legal Business Name | DEMIRJIAN NEUROLOGY & PAIN MANAGEMENT, INC.
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Dates
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Enumeration Date | 08/10/2007
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Last Update Date | 04/20/2008
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Provider Practice Location Address
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Address Line | 7034 CORPORATE WAY
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City | CENTERVILLE
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State | OH
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Zip | 45459-4237
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Country | US
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Telephone | 937-298-3800
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Fax | 937-296-0272
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Provider Business Mailing Address
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Address Line | 3732 BLOSSOM HEATH RD
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City | DAYTON
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State | OH
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Zip | 45419-1109
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Country | US
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Telephone | 937-298-3800
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. CHARLES DEMIRJIAN
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Credential | MD
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Telephone | 937-298-3800
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208VP0014X
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Taxonomy Name | Interventional Pain Medicine Physician
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License Number | 35048624D
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License Number State | OH
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