Provider Demographics
NPI:1629059845
Name:ROUPENIAN, ARMEN LEON (MD)
Entity Type:Individual
Prefix:MR
First Name:ARMEN
Middle Name:LEON
Last Name:ROUPENIAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1200 AIRPORT HEIGHTS DR
Mailing Address - Street 2:SUITE 220, TOWER E
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99508-2965
Mailing Address - Country:US
Mailing Address - Phone:907-929-2939
Mailing Address - Fax:866-549-7637
Practice Address - Street 1:1200 AIRPORT HEIGHTS DR
Practice Address - Street 2:SUITE 220, TOWER E
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508-2965
Practice Address - Country:US
Practice Address - Phone:907-929-2939
Practice Address - Fax:866-549-7637
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-07
Last Update Date:2016-10-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA39662174400000X
AK7643202K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes202K00000XAllopathic & Osteopathic PhysiciansPhlebology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AK1647541Medicaid