Provider Demographics
NPI:1114097326
Name:MOVSESIAN, DEBBIE S (PA-C)
Entity Type:Individual
Prefix:
First Name:DEBBIE
Middle Name:S
Last Name:MOVSESIAN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3452 GENESYS PKWY
Mailing Address - Street 2:
Mailing Address - City:GRAND BLANC
Mailing Address - State:MI
Mailing Address - Zip Code:48439-7334
Mailing Address - Country:US
Mailing Address - Phone:810-606-7550
Mailing Address - Fax:810-606-6235
Practice Address - Street 1:2620 GENESYS PKWY
Practice Address - Street 2:
Practice Address - City:GRAND BLANC
Practice Address - State:MI
Practice Address - Zip Code:48439-7326
Practice Address - Country:US
Practice Address - Phone:810-606-7954
Practice Address - Fax:810-606-6235
Is Sole Proprietor?:No
Enumeration Date:2006-11-08
Last Update Date:2014-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0E06345Medicare ID - Type UnspecifiedCARDIOVASCULAR CONSULTANT
MI0N95420Medicare ID - Type Unspecified