Dertad Manguikian is a Specialist in Fairfax, Virginia. Dertad Manguikian practices all healthcare services and medical treatments related to Specialist. The NPI Number for Dertad Manguikian is 1164645610. The last update date is 2023-11-25.
Dertad Manguikian's current location address is 9936 Main St, Fairfax, Virginia. You can contact this provider via phone number 7035914884 and fax number 7035916932. The mailing address for Dertad Manguikian is 9936 Main St, Fairfax, Virginia. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Dertad Manguikian |
|---|---|
| Address | 9936 Main St, Fairfax, Virginia |
| Phone Number | 7035914884 |
| Fax Number | 7035916932 |
| Sole Proprietor | Y |
| Credentials | M.D. |
NPI Number Detail
| NPI Number | 1164645610 |
|---|---|
| Provider Enumeration Date | 2007-04-11 |
| Last Updated Date | 2023-11-25 |
Provider Mailing Address Detail
| Address | 9936 Main St |
|---|---|
| City | Fairfax |
| State | Virginia (VA) |
| Post Code | 220313901 |
| Phone Number | 7035914884 |
| Fax Number | 7035916932 |
Provider's Primary Taxonomy Detail
| Speciality | Specialist |
|---|---|
| Taxonomy | 174400000X |
| Licence No | 101024017 |
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Definition: An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 6343643 | VA | -- | |
| 101024017 | VA | MEDICAL LICENSE |
Post Comment/ Review Below
What is the unique 10-digit identifier code issued to Dertad Manguikian by the Centers for Medicare & Medicaid Services?
The Dertad Manguikian has been assigned the NPI (National Provider Identifier) 1164645610 by the CMS (Centers for Medicare & Medicaid Services). This 10-digit code serves as a unique identification number for healthcare providers.
Where is the Dertad Manguikian located?
The Dertad Manguikian is located at 9936 Main St, Fairfax, VA 220313901.
What is Dertad Manguikian's primary area of medical expertise, and what taxonomy classification code corresponds to this specialized field?
The primary area of medical expertise for Dertad Manguikian is Specialist, and the corresponding taxonomy classification code for this specialized field is 174400000X.
On what date did the Dertad Manguikian receive the assignment of its 1164645610 from the Centers for Medicare & Medicaid Services?
The Dertad Manguikian was issued its 1164645610 by the Centers for Medicare & Medicaid Services on 2007-04-11.
As of what date was the information regarding Dertad Manguikian, such as address, specialty, and other details, last verified and confirmed to be up-to-date?
The information related to Dertad Manguikian, including its address, specialty, and other relevant details, was last verified and confirmed to be up-to-date on 2023-11-25.