Individual
JARED P TADJE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2365 E GALA ST STE 1, MERIDIAN, ID 83642
(208) 515-2654
(877) 587-3112
Mailing address
1940 S BONITO WAY STE 190, MERIDIAN, ID 83642-5618
(208) 287-9420
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
11808
NV
207X00000X
Orthopaedic Surgery Physician
A95193
CA
207X00000X
Orthopaedic Surgery Physician
Primary
M9901
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
76938
BLUE CROSS
ID
Enumeration date
08/03/2006
Last updated
02/27/2023
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