Provider Demographics
NPI:1285826867
Name:TAUSCH, VALERIE S (MD)
Entity Type:Individual
Prefix:
First Name:VALERIE
Middle Name:S
Last Name:TAUSCH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1224 PENNSYLVANIA ST NE
Mailing Address - Street 2:B
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87110-7438
Mailing Address - Country:US
Mailing Address - Phone:505-255-1512
Mailing Address - Fax:505-255-1513
Practice Address - Street 1:1224 PENNSYLVANIA ST NE
Practice Address - Street 2:B
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87110-7438
Practice Address - Country:US
Practice Address - Phone:505-255-1512
Practice Address - Fax:505-255-1513
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-16
Last Update Date:2009-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM2007-0747207K00000X, 207R00000X
FL68829207R00000X, 207RA0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RA0201XAllopathic & Osteopathic PhysiciansInternal MedicineAllergy & Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NMNMB2121Medicare PIN