MEDICARE: ARMEN E NIKOGOSIAN MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist	10614	NV
2	207R00000X	Internal Medicine Physician	10614	NV

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1467546911
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ARMEN E NIKOGOSIAN MD

Provider Business Mailing Address
First Line	:	5380 S RAINBOW BLVD
Second Line	:	SUITE 306
City	:	LAS VEGAS
State	:	NV
Zip	:	89118-1899
Country	:	US
Telephone Number	:	702-362-9930
Fax Number	:	702-362-9954

Provider Business Practice Location Address
First Line	:	5380 S RAINBOW BLVD
Second Line	:	SUITE 306
City	:	LAS VEGAS
State	:	NV
Zip	:	89118-1899
Country	:	US
Telephone Number	:	702-362-9930
Fax Number	:	702-362-9954

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/02/2006
Last Update Date	:	03/18/2011

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