Individual
TARAKARAMA DUTT MUSUNURI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
9040 JACKSON AVE, TACOMA, WA 98431-5270
(510) 676-3031
Mailing address
43187 GALLEGOS AVE APT A, FREMONT, CA 94539-5270
(510) 676-3031
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
OP61460517
WA
208D00000X
General Practice Physician
0102206974
VA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/20/2020
Last updated
01/01/2024
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