Provider Demographics
NPI:1295059855
Name:TARJAN, ANDREA VERONIKA (MD)
Entity type:Individual
Prefix:DR
First Name:ANDREA
Middle Name:VERONIKA
Last Name:TARJAN
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 1:3113 SATINWOOD DR
Mailing Address - Street 2:
Mailing Address - City:JANESVILLE
Mailing Address - State:WI
Mailing Address - Zip Code:53546-8868
Mailing Address - Country:US
Mailing Address - Phone:608-754-2830
Mailing Address - Fax:
Practice Address - Street 1:3113 SATINWOOD DR
Practice Address - Street 2:
Practice Address - City:JANESVILLE
Practice Address - State:WI
Practice Address - Zip Code:53546-8868
Practice Address - Country:US
Practice Address - Phone:608-754-2830
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-24
Last Update Date:2010-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI33580207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine