Healthcare Provider Details

I. General information

NPI: 1154704773
Provider Name (Legal Business Name): TARIN PAPARELLA DPM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/01/2015
Last Update Date: 05/23/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

561 SEMINOLE RD
NORTON SHORES MI
49444
US

IV. Provider business mailing address

561 SEMINOLE RD
NORTON SHORES MI
49444-3719
US

V. Phone/Fax

Practice location:
  • Phone: 231-733-1111
  • Fax:
Mailing address:
  • Phone: 231-733-1111
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number5901002599
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: