Provider Demographics
NPI:1114906237
Name:MERIJANIAN, GRIGOR VARTAN (MD)
Entity Type:Individual
Prefix:
First Name:GRIGOR
Middle Name:VARTAN
Last Name:MERIJANIAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:GREG
Other - Middle Name:V
Other - Last Name:MERIJANIAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:2006 FRANKLIN ST SE
Mailing Address - Street 2:STE 301
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35801-4551
Mailing Address - Country:US
Mailing Address - Phone:256-539-9471
Mailing Address - Fax:256-539-9472
Practice Address - Street 1:101 SIVLEY RD SW
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801-4421
Practice Address - Country:US
Practice Address - Phone:256-265-1000
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-17
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL00012811207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL51523701OtherBCBS MADISON SURG CTR
TN4019964OtherBCBS TN
AL51028222OtherBCBS HH LOCATIONS
AL51028222OtherBCBS HH LOCATIONS