Provider Demographics
NPI:1578571501
Name:KARABAJAKIAN, MARK Z (DO)
Entity Type:Individual
Prefix:
First Name:MARK
Middle Name:Z
Last Name:KARABAJAKIAN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1435 N MILFORD RD
Mailing Address - Street 2:STE 201
Mailing Address - City:MILFORD
Mailing Address - State:MI
Mailing Address - Zip Code:48381-1015
Mailing Address - Country:US
Mailing Address - Phone:248-305-8707
Mailing Address - Fax:248-685-8039
Practice Address - Street 1:1435 N MILFORD RD STE 201
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:MI
Practice Address - Zip Code:48381-1015
Practice Address - Country:US
Practice Address - Phone:248-676-8889
Practice Address - Fax:248-685-8039
Is Sole Proprietor?:No
Enumeration Date:2006-08-04
Last Update Date:2021-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI220010207UN0901X
MI5101011367207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207UN0901XAllopathic & Osteopathic PhysiciansNuclear MedicineNuclear Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIP00061832OtherRAILROAD MEDICARE
MI114578887Medicaid
MI0656310564OtherBCBS
MI0P15910001Medicare PIN
MI0656310564OtherBCBS