Doctor Name: | TIGRAN MARTIKYAN |
NPI Number: | 1538425814 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | |
Business Practice Address: | 3640 New Vision Dr Fort Wayne, IN - 468451716 |
Business Phone Number: | 2604825091 |
Business Fax Number: | |
Mailing Address: | 2410 Island Club Dr Apt B, FORT WAYNE |
State: | IN |
Postal Code: | 468253076 |
Phone Number: | 8184339915 |
Fax Number: | |
NPI Enumeration Date: | 04/11/2012 |
NPI Last Update Date: | 03/23/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 390200000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | TX |
Taxonomy Type: | Student, Health Care |
Taxonomy Classification: | Student in an Organized Health Care Education/Training Program |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |