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Individual

DR. GEVORG MARTIROSYAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PHARMD

Contact information

Practice address
615 N MICHIGAN ST, SOUTH BEND, IN 46601-1033
(574) 647-3119
Mailing address
615 N MICHIGAN ST, SOUTH BEND, IN 46601-1033
(574) 647-3119

Taxonomy

Speciality
Code
Description
License number
State
1835P0018X
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
Primary
26027468A
IN
390200000X
Student in an Organized Health Care Education/Training Program
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
26027468A
PHARMACIST
IN
01
PENDING
STATE LICENSE
IN
Enumeration date
06/08/2017
Last updated
01/18/2026
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