Provider Demographics
NPI:1932695665
Name:PARAJULI, TILACHAN (MD)
Entity Type:Individual
Prefix:
First Name:TILACHAN
Middle Name:
Last Name:PARAJULI
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 1:105 GOVERNORS CT APT H
Mailing Address - Street 2:
Mailing Address - City:GLEN BURNIE
Mailing Address - State:MD
Mailing Address - Zip Code:21061-3166
Mailing Address - Country:US
Mailing Address - Phone:443-433-2473
Mailing Address - Fax:
Practice Address - Street 1:400 TAYLOR RD
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36117-3512
Practice Address - Country:US
Practice Address - Phone:334-277-8330
Practice Address - Fax:334-244-8119
Is Sole Proprietor?:No
Enumeration Date:2018-07-05
Last Update Date:2021-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
AL42908207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program