Provider Demographics
NPI:1265932545
Name:TAKAHASHI, NOBUYUKI (MD)
Entity type:Individual
Prefix:
First Name:NOBUYUKI
Middle Name:
Last Name:TAKAHASHI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9609 MEDICAL CENTER DRIVE
Mailing Address - Street 2:
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20892-9760
Mailing Address - Country:US
Mailing Address - Phone:301-496-5800
Mailing Address - Fax:
Practice Address - Street 1:9609 MEDICAL CENTER DRIVE
Practice Address - Street 2:
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20892-9760
Practice Address - Country:US
Practice Address - Phone:301-496-5800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-13
Last Update Date:2018-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ZZ101931207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine