Organization
MARAPOSA SURGICAL INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBERT WAYNE TAHARA M.D. (PRESIDENT)
(814) 368-8490
Entity
Organization
Contact information
Practice address
900 CHESTNUT STREET EXT, STE A, BRADFORD, PA 16701-2298
(814) 368-8490
(814) 368-8041
Mailing address
900 CHESTNUT STREET EXT, STE A, BRADFORD, PA 16701-2298
(814) 368-8490
(814) 368-8041
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
MD419351
PA
2086S0129X
Vascular Surgery Physician
Primary
MD419351
PA
Other
Enumeration date
09/03/2008
Last updated
03/23/2016
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