K. Hamamdjian MD PC

Primary specialty

SpecialistTaxonomy code 174400000X

License

4301037656 Issued in MI

Legal business name

K. HAMAMDJIAN MD PC

Practice address

27177 Lahser Rd
Suite 104
Southfield, MI 48034-4714

Phone

(248) 353-6580

Fax

(248) 353-0883

NPI assigned

Dec 9, 2005

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Khatchadour Wahan Hamamdjian, MD

Title

President

Phone

(248) 642-1389

Specialties & licenses 1

Addresses

Other identifiers 9

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1134086400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1322611200000",
    "number": "1407831795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 MANORWOOD DR",
            "city": "BLOOMFIELD HILLS",
            "state": "MI",
            "postal_code": "483042133",
            "telephone_number": "248-642-1389",
            "fax_number": "248-353-0883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27177 LAHSER RD",
            "address_2": "SUITE 104",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480344714",
            "telephone_number": "248-353-6580",
            "fax_number": "248-353-0883"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "K. HAMAMDJIAN MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-09",
        "last_updated": "2011-11-30",
        "status": "A",
        "authorized_official_last_name": "HAMAMDJIAN",
        "authorized_official_first_name": "KHATCHADOUR",
        "authorized_official_middle_name": "WAHAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "248-642-1389",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "MI",
            "license": "4301037656",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA INSURANCE",
            "identifier": "4557191",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD MI",
            "identifier": "280F339180",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4137828",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CARE CHOICE HMO",
            "identifier": "128807",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA INS.",
            "identifier": "2440249001",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTH CARE",
            "identifier": "354121",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED CHOICE PPO",
            "identifier": "128807",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "280000118",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH ALLIANCE PLAN",
            "identifier": "A78356",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Specialist in Southfield, MI
• Providers in Southfield, MI by specialty
• Specialist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.