Provider Demographics
NPI:1467428755
Name:FLAHERTY TUEGEL AND GOODMAN PA
Entity Type:Organization
Organization Name:FLAHERTY TUEGEL AND GOODMAN PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL CIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:
Authorized Official - Last Name:TEUGEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:410-848-8202
Mailing Address - Street 1:18111 PRINCE PHILIP DR
Mailing Address - Street 2:STE 323
Mailing Address - City:OLNEY
Mailing Address - State:MD
Mailing Address - Zip Code:20832-1513
Mailing Address - Country:US
Mailing Address - Phone:410-848-8202
Mailing Address - Fax:410-848-2644
Practice Address - Street 1:18111 PRINCE PHILIP DR
Practice Address - Street 2:STE 323
Practice Address - City:OLNEY
Practice Address - State:MD
Practice Address - Zip Code:20832-1513
Practice Address - Country:US
Practice Address - Phone:410-848-8202
Practice Address - Fax:410-848-2644
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-27
Last Update Date:2010-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD831398OtherUNITED HEALTHCARE(P)
MD231398OtherUNIITED HEALTHCARE (S)
MD750471300Medicaid
MDKX28CAOtherBC MD
DC0119OtherBC DC/METRO
MD231398OtherUNIITED HEALTHCARE (S)