Provider Demographics
NPI:1821230202
Name:TAUB, ALBERT
Entity Type:Individual
Prefix:
First Name:ALBERT
Middle Name:
Last Name:TAUB
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8218 WISCONSIN AVE.
Mailing Address - Street 2:410
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20814-3633
Mailing Address - Country:US
Mailing Address - Phone:301-656-0119
Mailing Address - Fax:301-340-3281
Practice Address - Street 1:8218 WISCONSIN AVE.
Practice Address - Street 2:410
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20814-3633
Practice Address - Country:US
Practice Address - Phone:301-656-0119
Practice Address - Fax:301-340-3281
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-31
Last Update Date:2009-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD00133292084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDB94277Medicare UPIN