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Individual

THARENIE SIVARAJAH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
820 EAST 17TH STREET, CHEYENNE, WY 82001-4797
(307) 632-2434
(307) 634-3510
Mailing address
820 EAST 17TH STREET, CHEYENNE, WY 82001-4797
(307) 632-2434
(307) 634-3510

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
032-T2
WY
207Q00000X
Family Medicine Physician
293430
NY

Other

Enumeration date
07/18/2012
Last updated
07/03/2023
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