Provider Demographics
NPI:1407296676
Name:GAIGE, TASHA RUTH (MD)
Entity Type:Individual
Prefix:
First Name:TASHA
Middle Name:RUTH
Last Name:GAIGE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:13856 N DALE MABRY HWY
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33618-2420
Mailing Address - Country:US
Mailing Address - Phone:304-243-3880
Mailing Address - Fax:813-264-1885
Practice Address - Street 1:40 MEDICAL PARK
Practice Address - Street 2:SUITE 401
Practice Address - City:WHEELING
Practice Address - State:WV
Practice Address - Zip Code:26003
Practice Address - Country:US
Practice Address - Phone:304-243-3880
Practice Address - Fax:304-243-3895
Is Sole Proprietor?:No
Enumeration Date:2013-07-02
Last Update Date:2018-05-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
390200000X
FLME113548207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program