Healthcare Provider Details

I. General information

NPI: 1467428755
Provider Name (Legal Business Name): FLAHERTY TUEGEL AND GOODMAN PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/27/2006
Last Update Date: 10/18/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18111 PRINCE PHILIP DR STE 323
OLNEY MD
20832-1513
US

IV. Provider business mailing address

18111 PRINCE PHILIP DR STE 323
OLNEY MD
20832-1513
US

V. Phone/Fax

Practice location:
  • Phone: 410-848-8202
  • Fax: 410-848-2644
Mailing address:
  • Phone: 410-848-8202
  • Fax: 410-848-2644

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State

VIII. Authorized Official

Name: CHARLES TEUGEL
Title or Position: MEDICAL CIRECTOR
Credential: M.D.
Phone: 410-848-8202