Provider Demographics
NPI:1275551244
Name:GRIGORIAN, ALLA Y (MD)
Entity Type:Individual
Prefix:
First Name:ALLA
Middle Name:Y
Last Name:GRIGORIAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:UK DIVISION OF DIGESTIVE DISEASES
Mailing Address - Street 2:800 ROSE STREET, MN654 MED SCIENCE BLDG
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40536-0298
Mailing Address - Country:US
Mailing Address - Phone:859-323-4887
Mailing Address - Fax:859-257-8860
Practice Address - Street 1:UK DIVISION OF DIGESTIVE DISEASES
Practice Address - Street 2:800 ROSE STREET, MN654 MED SCIENCE BLDG
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40536-0298
Practice Address - Country:US
Practice Address - Phone:859-323-4887
Practice Address - Fax:859-257-8860
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2014-09-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KY39535207R00000X, 207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100014180Medicaid
KYI65712Medicare UPIN
KY7100014180Medicaid