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NPI Code Detail

MEDICARE: DHEERAJ TARANATH DO

MEDICARE: DHEERAJ TARANATH DO
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician25MB08627700NJ
2207Q00000XFamily Medicine PhysicianC2-0010487DE
3207Q00000XFamily Medicine PhysicianOS012644PA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1881646248
Entity Type Code : Individual
Provider Name (Legal Business Name) : DHEERAJ TARANATH DO
Provider Business Mailing Address
First Line : 3407 N 5TH STREET HWY
Second Line :
City : READING
State : PA
Zip : 19605-2428
Country : US
Telephone Number : 610-939-8992
Fax Number :
Provider Business Practice Location Address
First Line : 16490 W 78TH ST
Second Line :
City : EDEN PRAIRIE
State : MN
Zip : 55346-4300
Country : US
Telephone Number : 952-934-5332
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/16/2006
Last Update Date : 12/15/2017

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Directions to “ DHEERAJ TARANATH DO” Practice Location

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