| Robert Tahara, MD | |
|
900 Chestnut Street Ext, Suite A, Bradford, PA 16701-2298 | |
| (814) 368-8490 | |
| (814) 368-8041 |
| Full Name | Robert Tahara |
|---|---|
| Gender | Male |
| Speciality | General Surgery |
| Experience | 32 Years |
| Location | 900 Chestnut Street Ext, Bradford, Pennsylvania |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902859069 | NPI | - | NPPES |
| 0019079900001 | Medicaid | PA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208600000X | Surgery | MD419351L (Pennsylvania) | Secondary |
| 2086S0129X | Surgery - Vascular Surgery | MD419351 (Pennsylvania) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Meadville Medical Center | Meadville, PA | Hospital |
| Penn Highlands Elk | Saint marys, PA | Hospital |
| Olean General Hospital | Olean, NY | Hospital |
| Upmc Cole | Coudersport, PA | Hospital |
| Entity Name | Meadville Physician Services |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1619236056 PECOS PAC ID: 9638078504 Enrollment ID: O20040108000834 |
| Entity Name | Maraposa Surgical Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1508014697 PECOS PAC ID: 8527029248 Enrollment ID: O20041025001077 |
| Mailing Address | Practice Location Address |
|---|---|
| Robert Tahara, MD 900 Chestnut Street Ext, Ste A, Bradford, PA 16701-2298 Ph: (814) 368-8490 | Robert Tahara, MD 900 Chestnut Street Ext, Suite A, Bradford, PA 16701-2298 Ph: (814) 368-8490 |
Nathaniel Lars Graham, M.D. Surgery Medicare: Not Enrolled in Medicare Practice Location: 116 Interstate Pkwy, Suite 31, Bradford, PA 16701 Phone: 814-368-7125 Fax: 814-368-9156 | |
Dr. Luis Carlos Gonzalez, M.D. Surgery Medicare: Accepting Medicare Assignments Practice Location: 181 Interstate Pkwy, Bradford, PA 16701 Phone: 814-362-4345 Fax: 814-362-1178 | |
Robert Raymond Harrie, MD Surgery Medicare: Not Enrolled in Medicare Practice Location: 116 Interstate Pkwy, Suite 31, Bradford, PA 16701 Phone: 814-362-8729 |