Provider Demographics
NPI:1962232744
Name:TAYOU, MICHEL WAWOUE
Entity type:Individual
Prefix:
First Name:MICHEL
Middle Name:WAWOUE
Last Name:TAYOU
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 1:3512 CHERRY HILL CT
Mailing Address - Street 2:
Mailing Address - City:BELTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20705-3654
Mailing Address - Country:US
Mailing Address - Phone:301-557-0451
Mailing Address - Fax:
Practice Address - Street 1:3512 CHERRY HILL CT
Practice Address - Street 2:
Practice Address - City:BELTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20705-3654
Practice Address - Country:US
Practice Address - Phone:301-557-0451
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-06
Last Update Date:2024-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator