Individual
BANIPAL HOVHANESSIAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2220 W ALTO RD, KOKOMO, IN 46902-4840
(765) 455-2577
(765) 455-0214
Mailing address
6626 E 75TH ST, SUITE 500, INDIANAPOLIS, IN 46250-2805
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100137220A
—
IN
01
—
P01270971
RR MEDICARE
IN
Enumeration date
05/15/2006
Last updated
12/22/2021
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