Individual
TARA M ROQUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
8600 OLD GEORGETOWN RD, BETHESDA, MD 20814-1422
(301) 896-3100
(301) 896-2393
Mailing address
PO BOX 791372, BALTIMORE, MD 21279-1372
(301) 608-8375
(301) 608-3979
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
D0061569
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
040143800
—
DC
01
—
19460029
CAREFIRST BCBS
DC
05
—
405306100
—
MD
05
—
415096100
—
MD
01
—
64460401
CAREFIRST BCBS
MD
Enumeration date
05/04/2006
Last updated
05/12/2009
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