Individual
ARA KASSARJIAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
250 NORTHWEST BLVD, SUITE #202, COEUR D ALENE, ID 83814-2974
(866) 400-4295
Mailing address
250 NORTHWEST BLVD, SUITE 202, COEUR D ALENE, ID 83814-2974
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
158749
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0169200
—
MA
Enumeration date
10/26/2005
Last updated
07/08/2007
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