Provider Demographics
NPI:1164661906
Name:DEMIRJIAN, ARAM NAZARETH (MD)
Entity Type:Individual
Prefix:DR
First Name:ARAM
Middle Name:NAZARETH
Last Name:DEMIRJIAN
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 1:300 MOUNT AUBURN ST STE 407
Mailing Address - Street 2:
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:02138-5665
Mailing Address - Country:US
Mailing Address - Phone:617-868-7456
Mailing Address - Fax:617-868-9243
Practice Address - Street 1:300 MOUNT AUBURN ST STE 407
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:02138-5665
Practice Address - Country:US
Practice Address - Phone:617-868-7456
Practice Address - Fax:617-868-9243
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-18
Last Update Date:2019-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD692712086X0206X
390200000X
MA269624208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No2086X0206XAllopathic & Osteopathic PhysiciansSurgerySurgical Oncology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD023227100Medicaid
MD154657YVEMedicare PIN