MEDICARE: REEMA TANEJA, M.D., INC.

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
1	207R00000X	Internal Medicine Physician	35073047	OH

Other Identifiers

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

General Provider Information

NPI Number	:	1073667168
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	REEMA TANEJA, M.D., INC.

Provider Business Mailing Address
First Line	:	1240 BOARDMAN CANFIELD RD
Second Line	:	SUITE # 1
City	:	BOARDMAN
State	:	OH
Zip	:	44512-4044
Country	:	US
Telephone Number	:	330-726-1900
Fax Number	:	330-726-0843

Provider Business Practice Location Address
First Line	:	1280 BOARDMAN CANFIELD RD STE 3
Second Line	:
City	:	BOARDMAN
State	:	OH
Zip	:	44512-4073
Country	:	US
Telephone Number	:	330-726-1900
Fax Number	:	330-726-0843

Authorized Official
Title or Position	:	OWNER
Name	:	DR. REEMA TANEJA
Credential	:	MD
Telephone Number	:	330-726-1900

Provider Enumeration Date	:	01/23/2007
Last Update Date	:	05/01/2024

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