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Individual

DR. JAMES MASEREJIAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
3700 WASHINGTON AVE, EVANSVILLE, IN 47714-0541
(812) 485-7040
(812) 485-7042
Mailing address
PO BOX 359, EVANSVILLE, IN 47703-0359
(812) 485-1220
(812) 485-8544

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
01051918A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000200708
ANTHEM PROVIDER #
IN
05
100180890G
IN
01
110232571
RAILROAD MEDICARE # IN
IN
05
200260050
IN
01
CH6490
GRPUP # RAILROAD MCR
IN
Enumeration date
06/10/2006
Last updated
11/13/2009
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