Individual
MR. CHARLES SARKIS KLANIAN, JR.
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
PHYSICIAN ASSISTANT
Contact information
Practice address
1201 BROAD ROCK BLVD, RICHMOND, VA 23249-0001
(804) 675-5403
Mailing address
11629 WOOD BLUFF LOOP, RICHMOND, VA 23236-2405
(804) 675-5403
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1004758
PA CERTIFICATION NUMBER
—
Enumeration date
05/11/2006
Last updated
07/08/2007
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