Provider Demographics
NPI:1801150529
Name:MINASKEIAN, NAREG (MD)
Entity type:Individual
Prefix:
First Name:NAREG
Middle Name:
Last Name:MINASKEIAN
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 1:5416 E BASELINE RD STE 129
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85206-4703
Mailing Address - Country:US
Mailing Address - Phone:480-945-4343
Mailing Address - Fax:480-945-4350
Practice Address - Street 1:7529 E BROADWAY RD STE 101
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85208-2007
Practice Address - Country:US
Practice Address - Phone:480-945-4343
Practice Address - Fax:480-945-4350
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-27
Last Update Date:2023-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA133209207R00000X, 207R00000X
AZ58372207RC0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac Electrophysiology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine