Provider Demographics
NPI:1023360351
Name:TAGHEU, BERTRAND (MD)
Entity Type:Individual
Prefix:MR
First Name:BERTRAND
Middle Name:
Last Name:TAGHEU
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 1:9777 GOOD LUCK RD APT 6
Mailing Address - Street 2:
Mailing Address - City:LANHAM
Mailing Address - State:MD
Mailing Address - Zip Code:20706-3337
Mailing Address - Country:US
Mailing Address - Phone:240-441-3892
Mailing Address - Fax:
Practice Address - Street 1:9777 GOOD LUCK RD APT 6
Practice Address - Street 2:
Practice Address - City:LANHAM
Practice Address - State:MD
Practice Address - Zip Code:20706-3337
Practice Address - Country:US
Practice Address - Phone:240-441-3892
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-10
Last Update Date:2012-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC39200000X390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program