Provider Demographics
NPI:1992925317
Name:PIERRE N. MOMJIAN, DPM, PC
Entity type:Organization
Organization Name:PIERRE N. MOMJIAN, DPM, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PIERRE
Authorized Official - Middle Name:N
Authorized Official - Last Name:MOMJIAN
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:928-710-4338
Mailing Address - Street 1:1041 PANICUM DR
Mailing Address - Street 2:
Mailing Address - City:PRESCOTT
Mailing Address - State:AZ
Mailing Address - Zip Code:86305-3831
Mailing Address - Country:US
Mailing Address - Phone:928-710-4338
Mailing Address - Fax:928-776-8623
Practice Address - Street 1:1041 PANICUM DR
Practice Address - Street 2:
Practice Address - City:PRESCOTT
Practice Address - State:AZ
Practice Address - Zip Code:86305-3831
Practice Address - Country:US
Practice Address - Phone:928-710-4338
Practice Address - Fax:928-776-8623
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ512213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty