Provider Demographics
NPI:1043289549
Name:OHANIAN, NESHAN V (MD)
Entity Type:Individual
Prefix:DR
First Name:NESHAN
Middle Name:V
Last Name:OHANIAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:N SEAN
Other - Middle Name:V
Other - Last Name:OHANIAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:3601 W 13 MILE RD
Mailing Address - Street 2:ANESTHESIOLOGY DEPT
Mailing Address - City:ROYAL OAK
Mailing Address - State:MI
Mailing Address - Zip Code:48073
Mailing Address - Country:US
Mailing Address - Phone:248-458-0400
Mailing Address - Fax:248-458-0310
Practice Address - Street 1:1719 W BIG BEAVER RD
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:MI
Practice Address - Zip Code:48084-3510
Practice Address - Country:US
Practice Address - Phone:248-458-0400
Practice Address - Fax:248-458-0310
Is Sole Proprietor?:No
Enumeration Date:2006-03-16
Last Update Date:2011-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301044970207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI161670510Medicaid
OF36192009Medicare ID - Type Unspecified
MI161670510Medicaid