Provider Demographics
NPI:1851396709
Name:NARAYAN, TAMARISA K (MD)
Entity Type:Individual
Prefix:DR
First Name:TAMARISA
Middle Name:K
Last Name:NARAYAN
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 1:939 OFFICE PARK RD STE 308
Mailing Address - Street 2:
Mailing Address - City:WEST DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50265-2538
Mailing Address - Country:US
Mailing Address - Phone:515-280-1252
Mailing Address - Fax:515-267-1183
Practice Address - Street 1:939 OFFICE PARK RD STE 308
Practice Address - Street 2:
Practice Address - City:WEST DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50265-2538
Practice Address - Country:US
Practice Address - Phone:515-280-1252
Practice Address - Fax:515-267-1183
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-16
Last Update Date:2007-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA23723207RC0200X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0207324Medicaid
IAA14475Medicare UPIN
IA0207324Medicaid