Individual
TARA M ROQUE
Active
Individual
TARA M ROQUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
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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