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1679929103
MAMIKON GUKASOV
CHARLESTON, SC
NPI
1679929103
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
207L00000X Anesthesiology
(Licence: SC 39233)
Enumeration Date
2016-05-13
Last Update Date
2020-11-25
Business Address
MAMIKON GUKASOV D.O
171 ASHLEY AVE
CHARLESTON, SC 29425-8905
Phone number: 843-792-1414
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Mailing Address
MAMIKON GUKASOV D.O
PO BOX 751461
CHARLOTTE, NC 28275-1461
Phone number: 843-792-6200
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