Provider Demographics
NPI:1588121586
Name:DEEPA TAGGARSHE MD PLLC
Entity type:Organization
Organization Name:DEEPA TAGGARSHE MD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DEEPA
Authorized Official - Middle Name:
Authorized Official - Last Name:TAGGARSHE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:248-557-9650
Mailing Address - Street 1:22250 PROVIDENCE DR STE 702
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48075-6215
Mailing Address - Country:US
Mailing Address - Phone:248-557-9650
Mailing Address - Fax:
Practice Address - Street 1:22250 PROVIDENCE DR STE 702
Practice Address - Street 2:
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48075-6215
Practice Address - Country:US
Practice Address - Phone:248-557-9650
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-26
Last Update Date:2019-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208C00000XAllopathic & Osteopathic PhysiciansColon & Rectal SurgeryGroup - Single Specialty