Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | DO210001308 | DC |
Y | 111NI0900X | Internist | DO210001308 | DC |
NPI | 1003313917 |
---|---|
Provider Name | Matthew John Taglieri |
First Address | Washington, DC 20037-1434 |
Second Address | Washington, DC 20037-1434 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/04/2018 |
Last Update Date | 15/10/2021 |