Individual
TARANNUM JALEEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
72 EAST CONCORD STREET, EVANS SUITE 124, BOSTON, MA 02118-2307
(617) 638-6513
Mailing address
PO BOX 63362, BOSTON UNIVERSITY MEDICAL CENTER, CHARLOTTE, NC 28263-3362
(919) 620-4918
(919) 620-4921
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
2016-01120
NC
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
04/05/2012
Last updated
08/02/2016
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