Provider Demographics
NPI:1477508877
Name:TARAZI, SYLVIA S (MD)
Entity Type:Individual
Prefix:DR
First Name:SYLVIA
Middle Name:S
Last Name:TARAZI
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 1:385 SERPENTINE DR
Mailing Address - Street 2:
Mailing Address - City:SPARTANBURG
Mailing Address - State:SC
Mailing Address - Zip Code:29303-3018
Mailing Address - Country:US
Mailing Address - Phone:864-560-7004
Mailing Address - Fax:864-560-7018
Practice Address - Street 1:385 SERPENTINE DR
Practice Address - Street 2:
Practice Address - City:SPARTANBURG
Practice Address - State:SC
Practice Address - Zip Code:29303-3018
Practice Address - Country:US
Practice Address - Phone:864-560-7004
Practice Address - Fax:864-560-7018
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-23
Last Update Date:2007-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC11751208600000X, 2086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCAT1979Medicaid
SC020002687OtherRAILROAD MEDICARE
SCC60759Medicare UPIN
SCAT1979Medicaid