Individual
SAMUEL AJIZIAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
MEDICAL CENTER BLVD, WINSTON SALEM, NC 27157-0001
(336) 716-2255
Mailing address
PO BOX 344, WINSTON SALEM, NC 27102-0344
(336) 716-2255
Taxonomy
Speciality
Code
Description
License number
State
207LP3000X
Pediatric Anesthesiology Physician
Primary
2001-01419
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
130GA
BCBS
—
05
—
2004816000
—
WV
01
—
45705
PARTNERS
—
05
—
6712738
—
VA
01
—
7153310
AETNA
—
05
—
89130GA
—
NC
01
—
B2548
MEDCOST
—
05
—
Q01419
—
SC
Enumeration date
03/01/2006
Last updated
06/24/2010
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