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Individual

DHEERAJ TARANATH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
16490 W 78TH ST, EDEN PRAIRIE, MN 55346-4300
(952) 934-5332
Mailing address
3407 N 5TH STREET HWY, READING, PA 19605-2428
(610) 939-8992

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
25MB08627700
NJ
207Q00000X
Family Medicine Physician
C2-0010487
DE
207Q00000X
Family Medicine Physician
Primary
OS012644
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
101465500001
PA
Enumeration date
05/16/2006
Last updated
12/15/2017
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