Provider Demographics
NPI:1447483664
Name:TARAKJI, MICHAEL SHUKRI (MD)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:SHUKRI
Last Name:TARAKJI
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:569 FURYS FERRY RD
Mailing Address - Street 2:
Mailing Address - City:MARTINEZ
Mailing Address - State:GA
Mailing Address - Zip Code:30907-9059
Mailing Address - Country:US
Mailing Address - Phone:706-724-5611
Mailing Address - Fax:706-724-5435
Practice Address - Street 1:569 FURYS FERRY RD
Practice Address - Street 2:
Practice Address - City:MARTINEZ
Practice Address - State:GA
Practice Address - Zip Code:30907-9059
Practice Address - Country:US
Practice Address - Phone:706-724-5611
Practice Address - Fax:706-724-5435
Is Sole Proprietor?:No
Enumeration Date:2009-09-03
Last Update Date:2020-07-22
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MI4301094197208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery