Provider Demographics
NPI:1336132893
Name:PIECH, TARA NICHOLE (MD)
Entity Type:Individual
Prefix:DR
First Name:TARA
Middle Name:NICHOLE
Last Name:PIECH
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Gender:F
Credentials:MD
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Mailing Address - Street 1:1050 JABARRAH AVE
Mailing Address - Street 2:SEYMOUR JOHNSON AFB
Mailing Address - City:GOLDSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27531-2310
Mailing Address - Country:US
Mailing Address - Phone:919-722-0928
Mailing Address - Fax:919-722-1952
Practice Address - Street 1:1050 JABARRAH AVE
Practice Address - Street 2:SEYMOUR JOHNSON AFB
Practice Address - City:GOLDSBORO
Practice Address - State:NC
Practice Address - Zip Code:27531-2310
Practice Address - Country:US
Practice Address - Phone:919-722-0928
Practice Address - Fax:919-722-1952
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-30
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
NC207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine