Individual
CHARLES IKNAYAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
N10561 GRANDVIEW LN, IRONWOOD, MI 49938-9622
(906) 932-2525
Mailing address
N10561 GRANDVIEW LN, IRONWOOD, MI 49938-9622
(906) 932-2525
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
4301044695
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2809457
—
MI
05
—
31778900
—
WI
01
—
CI044695
BLUE SHIELD PIN
MI
Enumeration date
07/24/2006
Last updated
07/09/2007
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