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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

TAHA BOURGO

Active Sole Proprietor

TAHA BOURGO is a Van Provider healthcare provider located in PRINCESS ANNE, Maryland. NPI 1972931285 is currently active in the NPPES registry. Verify at CMS.

Van Provider · PRINCESS ANNE, MD

Registration Details

NPI Number
1972931285
Provider Type
Individual
Gender
Male
NPI Issued
Oct 23, 2013 (12.805129531678 yrs)
Last Updated
Oct 23, 2013
License
B620785298002 (MD)
Sole Proprietor
Yes

Practice Information

Address
12450 INDEPENDENCE CT APT A5
PRINCESS ANNE, MD, 218533022
Browse MD providers · Browse ZIP 21853
Phone
4437222111
Primary Specialty
Van Provider
344600000X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.