Provider Demographics
NPI:1003915844
Name:GARABEDIAN, MAMIGON M (MD)
Entity Type:Individual
Prefix:
First Name:MAMIGON
Middle Name:M
Last Name:GARABEDIAN
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 1:36 LEICESTER RD
Mailing Address - Street 2:
Mailing Address - City:BELMONT
Mailing Address - State:MA
Mailing Address - Zip Code:02478-3325
Mailing Address - Country:US
Mailing Address - Phone:617-738-7300
Mailing Address - Fax:
Practice Address - Street 1:36 LEICESTER RD
Practice Address - Street 2:
Practice Address - City:BELMONT
Practice Address - State:MA
Practice Address - Zip Code:02478-3325
Practice Address - Country:US
Practice Address - Phone:617-738-7300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA33551207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology