Provider Demographics
NPI:1740627256
Name:TARAI, SARAH GRABOIS (MD)
Entity type:Individual
Prefix:DR
First Name:SARAH
Middle Name:GRABOIS
Last Name:TARAI
Suffix:
Gender:F
Credentials:MD
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Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:2705 N LEBANON ST
Mailing Address - Street 2:SUITE 305
Mailing Address - City:LEBANON
Mailing Address - State:IN
Mailing Address - Zip Code:46052-8621
Mailing Address - Country:US
Mailing Address - Phone:765-485-8900
Mailing Address - Fax:765-485-8909
Practice Address - Street 1:2705 N LEBANON ST
Practice Address - Street 2:SUITE 310
Practice Address - City:LEBANON
Practice Address - State:IN
Practice Address - Zip Code:46052-8621
Practice Address - Country:US
Practice Address - Phone:765-485-8900
Practice Address - Fax:765-485-8909
Is Sole Proprietor?:No
Enumeration Date:2013-05-24
Last Update Date:2016-06-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IN01076711A208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN201170430Medicaid