Provider Demographics
NPI:1457779100
Name:MORGAN, TARA NIKONOW (MD)
Entity Type:Individual
Prefix:DR
First Name:TARA
Middle Name:NIKONOW
Last Name:MORGAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MRS
Other - First Name:TARA
Other - Middle Name:NICOLE
Other - Last Name:NIKONOW
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:3471 5TH AVE STE 700
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15213-3232
Mailing Address - Country:US
Mailing Address - Phone:412-692-4091
Mailing Address - Fax:412-692-4101
Practice Address - Street 1:3471 5TH AVE STE 700
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15213-3232
Practice Address - Country:US
Practice Address - Phone:412-692-4091
Practice Address - Fax:412-692-4101
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-31
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
PAMT206574208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program