Individual
DR. ALBERT TEIKO TAGOE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
150 COUNTRY CLUB DR STE 100, STOCKBRIDGE, GA 30281-9089
(770) 474-3882
(404) 420-2091
Mailing address
150 COUNTRY CLUB DR STE 100, STOCKBRIDGE, GA 30281-9089
(770) 474-3882
(770) 474-9392
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
033720
GA
2086S0129X
Vascular Surgery Physician
33720
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000443198D
—
GA
05
—
00443198C
—
GA
Enumeration date
03/31/2006
Last updated
03/06/2024
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