Provider Demographics
NPI:1063779742
Name:EKIZIAN, MICHAEL ARMEN (MD)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:ARMEN
Last Name:EKIZIAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12202 CLEARFORK DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77077-2513
Mailing Address - Country:US
Mailing Address - Phone:281-870-9394
Mailing Address - Fax:281-589-9275
Practice Address - Street 1:630 CHERRY TREE LN
Practice Address - Street 2:
Practice Address - City:UNIONTOWN
Practice Address - State:PA
Practice Address - Zip Code:15401-8947
Practice Address - Country:US
Practice Address - Phone:724-439-0308
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-04-18
Last Update Date:2016-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD438929208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice