Provider Demographics
NPI:1114108644
Name:MEHRANI, TARANEH (MD)
Entity type:Individual
Prefix:DR
First Name:TARANEH
Middle Name:
Last Name:MEHRANI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:W207N5530 CARTERS CROSSING CIR
Mailing Address - Street 2:
Mailing Address - City:MENOMONEE FALLS
Mailing Address - State:WI
Mailing Address - Zip Code:53051-6286
Mailing Address - Country:US
Mailing Address - Phone:301-651-5802
Mailing Address - Fax:
Practice Address - Street 1:W207N5530 CARTERS CROSSING CIR
Practice Address - Street 2:
Practice Address - City:MENOMONEE FALLS
Practice Address - State:WI
Practice Address - Zip Code:53051-6286
Practice Address - Country:US
Practice Address - Phone:301-651-5802
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-11-27
Last Update Date:2025-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN78264207RR0500X
WI64103207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1114108644Medicaid
MS04971530Medicaid