Active NPI
Charles G. Papazian, CSA
- Surgical Physician Assistant
- Dearborn, MI
National Provider Identifier
1013126747
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgical Physician Assistant
- License
- 1056
- Practice address
- 18101 Oakwoo0D Blvd
Dearborn, MI 48124 - Phone
- (313) 593-7408
- NPI assigned
- May 21, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgical Physician Assistant | 363AS0400X | 1056 | MI | Primary |
Addresses
Primary practice location
18101 Oakwoo0D Blvd
Dearborn, MI 48124
Mailing address
415 Princess Dr
Canton, MI 48188-1190
Phone (734) 981-1983
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1056 | MI | MD | Surgical Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179705600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1013126747",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "415 PRINCESS DR",
"city": "CANTON",
"state": "MI",
"postal_code": "481881190",
"telephone_number": "734-981-1983"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "18101 OAKWOO0D BLVD",
"city": "DEARBORN",
"state": "MI",
"postal_code": "48124",
"telephone_number": "313-593-7408"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PAPAZIAN",
"first_name": "CHARLES",
"middle_name": "G.",
"name_prefix": "Mr.",
"credential": "CSA",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-05-21",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "363AS0400X",
"taxonomy_group": "",
"desc": "Physician Assistant, Surgical",
"state": "MI",
"license": "1056",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dearborn, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.