Individual
ROBERT TAHARA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
900 CHESTNUT STREET EXT, SUITE A, BRADFORD, PA 16701-2298
(814) 368-8490
(814) 368-8041
Mailing address
900 CHESTNUT STREET EXT, STE A, BRADFORD, PA 16701-2298
(814) 368-8490
(814) 368-8490
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
MD419351L
PA
2086S0129X
Vascular Surgery Physician
Primary
MD419351
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0019079900001
—
PA
Enumeration date
05/18/2006
Last updated
03/23/2016
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