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General NPI Number Information
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NPI Number | 1679535405
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Entity Type | Individual
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Provider Name | TALA SERI DAJANI M.D., M.P.H
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Gender | Female
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Dates
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Enumeration Date | 04/05/2006
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Last Update Date | 06/28/2024
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Provider Practice Location Address
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Address Line | 100 MEDICAL PARK DR STE 310E
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City | CONCORD
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State | NC
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Zip | 28025-2966
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Country | US
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Telephone | 704-403-2660
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Fax | 704-782-6032
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Provider Business Mailing Address
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Address Line | 95 SUNWEST DR
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City | ARDEN
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State | NC
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Zip | 28704-8550
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Country | US
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Telephone | 704-403-2660
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Fax | 704-782-6032
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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 | 2080P0205X
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Taxonomy Name | Pediatric Endocrinology Physician
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License Number | 28837
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 2080P0205X
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Taxonomy Name | Pediatric Endocrinology Physician
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License Number | 2021-03357
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License Number State | NC
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