MEDICARE: STEM ARTASHESYAN MD PLLC

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	207RA0000X	Adolescent Medicine (Internal Medicine) Physician
2	207R00000X	Internal Medicine Physician

General Provider Information

NPI Number	:	1659082683
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	STEM ARTASHESYAN MD PLLC

Provider Business Mailing Address
First Line	:	5546 LONGLEY LN STE B
Second Line	:
City	:	RENO
State	:	NV
Zip	:	89511-1883
Country	:	US
Telephone Number	:	775-384-3867
Fax Number	:

Provider Business Practice Location Address
First Line	:	5546 LONGLEY LN STE B
Second Line	:
City	:	RENO
State	:	NV
Zip	:	89511-1883
Country	:	US
Telephone Number	:	775-384-3867
Fax Number	:	561-461-6175

Authorized Official
Title or Position	:	MANAGING MEMBER
Name	:	ARSHAVIR ARTASHESYAN
Credential	:	MD
Telephone Number	:	775-384-3867

Provider Enumeration Date	:	12/12/2022
Last Update Date	:	12/14/2022

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