1427219997 NPI number — VICKEN POOCHIKIAN MD P A

Table of content: (NPI 1427219997)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1427219997 NPI number — VICKEN POOCHIKIAN MD P A

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
VICKEN POOCHIKIAN MD P A
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1427219997
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/19/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5632 ANNAPOLIS RD
Provider Second Line Business Mailing Address:
SUITE 3
Provider Business Mailing Address City Name:
BLADENSBURG
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
20710-2213
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
301-779-7607
Provider Business Mailing Address Fax Number:
301-927-0335

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5632 ANNAPOLIS RD
Provider Second Line Business Practice Location Address:
SUITE 3
Provider Business Practice Location Address City Name:
BLADENSBURG
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
20710-2213
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
301-779-7607
Provider Business Practice Location Address Fax Number:
301-927-0335
Provider Enumeration Date:
06/18/2008

Additional Information

Authorized Official

Authorized Official Last Name:
POOCHIKIAN
Authorized Official First Name:
VICKEN
Authorized Official Middle Name:
Authorized Official Title or Position:
SOLE OWNER M.D.
Authorized Official Telephone Number:
301-779-7607

Provider Taxonomy Codes

  • Taxonomy code: 207R00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1174568463 . This is a "INDIVIDUAL NPI" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com