=====================================================
General NPI Number Information
=====================================================
NPI Number | 1841547957
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | TAMAR ACHJIAN M.D.
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/08/2012
-----------------------------------------------------
Last Update Date | 06/21/2016
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3RD FLOOR, A45 BUILDING, 6TH STREET
-----------------------------------------------------
City | RABOUEH
-----------------------------------------------------
State | MATEN
-----------------------------------------------------
Zip | 9614
-----------------------------------------------------
Country | LB
-----------------------------------------------------
Telephone | 009613898948
-----------------------------------------------------
Fax | 009611494939
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 80134
-----------------------------------------------------
City | BOURJ HAMMOUD
-----------------------------------------------------
State | BEIRUT
-----------------------------------------------------
Zip | 5571
-----------------------------------------------------
Country | LB
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207V00000X
-----------------------------------------------------
Taxonomy Name | Obstetrics & Gynecology Physician
-----------------------------------------------------
License Number | BP10043755
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------