Provider Demographics
NPI:1790703023
Name:RICHARDSON, TARYN (MD)
Entity Type:Individual
Prefix:DR
First Name:TARYN
Middle Name:
Last Name:RICHARDSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:12164 CENTRAL AVE
Mailing Address - Street 2:SUITE 225
Mailing Address - City:MITCHELLVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20721-1944
Mailing Address - Country:US
Mailing Address - Phone:240-206-9601
Mailing Address - Fax:240-206-9072
Practice Address - Street 1:12164 CENTRAL AVE
Practice Address - Street 2:SUITE 225
Practice Address - City:MITCHELLVILLE
Practice Address - State:MD
Practice Address - Zip Code:20721-1944
Practice Address - Country:US
Practice Address - Phone:240-206-9601
Practice Address - Fax:240-206-9072
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-17
Last Update Date:2022-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2005-01555207K00000X
MDD68780207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology