Provider Demographics
NPI:1750497863
Name:TARAKJI, MUHAMMAD ANAS (MD)
Entity Type:Individual
Prefix:
First Name:MUHAMMAD
Middle Name:ANAS
Last Name:TARAKJI
Suffix:
Gender:M
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:PO BOX 840063
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75284-0063
Mailing Address - Country:US
Mailing Address - Phone:505-727-5155
Mailing Address - Fax:505-727-5189
Practice Address - Street 1:715 DR MARTIN LUTHER KING JR AVE NE STE 102
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87102-3666
Practice Address - Country:US
Practice Address - Phone:505-727-3040
Practice Address - Fax:505-727-9590
Is Sole Proprietor?:No
Enumeration Date:2006-08-22
Last Update Date:2022-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMMD2011-0601207R00000X, 207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine