Individual
TAHA BOURGO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
12450 INDEPENDENCE CT APT A5, PRINCESS ANNE, MD 21853-3022
(443) 722-2111
Mailing address
12450 INDEPENDENCE CT APT A5, PRINCESS ANNE, MD 21853-3022
(443) 722-2111
Taxonomy
Speciality
Code
Description
License number
State
344600000X
Taxi
Primary
B620785298002
MD
Other
Enumeration date
10/23/2013
Last updated
10/23/2013
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