Provider Demographics
NPI:1982745212
Name:ARJA, TAREK T (DO)
Entity type:Individual
Prefix:DR
First Name:TAREK
Middle Name:T
Last Name:ARJA
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:525 NORTH AVE
Mailing Address - Street 2:
Mailing Address - City:GRAND JUNCTION
Mailing Address - State:CO
Mailing Address - Zip Code:81501-7512
Mailing Address - Country:US
Mailing Address - Phone:970-424-5030
Mailing Address - Fax:970-424-5033
Practice Address - Street 1:525 NORTH AVE
Practice Address - Street 2:
Practice Address - City:GRAND JUNCTION
Practice Address - State:CO
Practice Address - Zip Code:81501-7512
Practice Address - Country:US
Practice Address - Phone:970-424-5030
Practice Address - Fax:970-424-5033
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-09
Last Update Date:2012-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO31818207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
F83948Medicare UPIN
COC810023Medicare PIN