Individual
ROBERT G TAYENGCO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2007 SECOND STREET, MASON, WV 25260
(304) 773-5195
(304) 675-5167
Mailing address
PO BOX 236, PT PLEASANT, WV 25550-0236
(304) 675-1020
(304) 675-5893
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
19087
WV
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
19087
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000026375
BCBS
WA
05
—
0080756000
—
WV
05
—
2028755
—
OH
01
—
230077
FEDERAL BLACK LUNG
WV
01
—
550737600
COMMERICAL INSURANCE
WV
Enumeration date
09/26/2006
Last updated
01/23/2008
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