Provider Demographics
NPI:1417136391
Name:HAIG H. YENI-KOMSHIAN MD FACOG LLC
Entity Type:Organization
Organization Name:HAIG H. YENI-KOMSHIAN MD FACOG LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:HAIG
Authorized Official - Middle Name:HOVSEP
Authorized Official - Last Name:YENI-KOMSHIAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:301-656-5920
Mailing Address - Street 1:5530 WISCONSIN AVE
Mailing Address - Street 2:715
Mailing Address - City:CHEVY CHASE
Mailing Address - State:MD
Mailing Address - Zip Code:20815-4404
Mailing Address - Country:US
Mailing Address - Phone:301-656-5920
Mailing Address - Fax:301-654-2559
Practice Address - Street 1:5530 WISCONSIN AVE
Practice Address - Street 2:715
Practice Address - City:CHEVY CHASE
Practice Address - State:MD
Practice Address - Zip Code:20815-4404
Practice Address - Country:US
Practice Address - Phone:301-656-5920
Practice Address - Fax:301-654-2559
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-29
Last Update Date:2007-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDG01221Medicare PIN