Individual
DR. TAEGEE KIEHM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5215 HOLY CROSS PARKWAY, MISHAWAKA, IN 46545-1469
(574) 237-7168
(574) 472-6262
Mailing address
810 PARK PL, MISHAWAKA, IN 46545-3520
(574) 472-6700
(574) 472-6746
Taxonomy
Speciality
Code
Description
License number
State
173000000X
Legal Medicine
01027437
IN
207R00000X
Internal Medicine Physician
Primary
01027437A
IN
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
01027437A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000612786
BCBS
IN
05
—
100222770
—
IN
Enumeration date
10/04/2005
Last updated
12/17/2009
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