Individual
ROGER TATARIAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1818 N MEADE ST, APPLETON, WI 54911-3454
(920) 731-4101
Mailing address
203 DESPLAINE RD, DE PERE, WI 54115-3726
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
200090-30
WI
Other
Enumeration date
08/11/2016
Last updated
01/23/2024
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