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General NPI Number Information
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NPI Number | 1285692749
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Entity Type | Individual
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Provider Name | RICHARD J TARAS DO
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Gender | Male
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Dates
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Enumeration Date | 05/03/2006
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Last Update Date | 09/15/2010
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Provider Practice Location Address
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Address Line | 24285 KARIM BLVD
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City | NOVI
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State | MI
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Zip | 48375-2952
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Country | US
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Telephone | 248-536-0410
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Fax | 248-536-0420
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Provider Business Mailing Address
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Address Line | PO BOX 72293
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City | CLEVELAND
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State | OH
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Zip | 44192-0002
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Country | US
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Telephone | 734-462-3232
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Fax | 248-449-7103
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 5101005725
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License Number State | MI
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