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Individual

DR. GERALD T. TARIRAH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D

Contact information

Practice address
770 PINE STREET, SUITE 560, MACON, GA 31201
(478) 745-9998
(478) 745-9981
Mailing address
770 PINE STREET, SUITE 560, MACON, GA 31201
(478) 745-9998
(478) 745-9981

Taxonomy

Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
065904
GA
207RP1001X
Pulmonary Disease Physician
19405
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
003110501C
GA
05
003110501F
GA
05
02404007
MS
01
P01686239
RAILROAD MEDICARE PTAN
GA
Enumeration date
07/24/2006
Last updated
10/07/2016
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