MEDICARE: DR. NADU A TUAKLI M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	D0038183	MD

General Provider Information

NPI Number	:	1811943392
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NADU A TUAKLI M.D.

Provider Business Mailing Address
First Line	:	10814 HICKORY RIDGE RD
Second Line	:
City	:	COLUMBIA
State	:	MD
Zip	:	21044-3622
Country	:	US
Telephone Number	:	410-992-0011
Fax Number	:	410-992-1606

Provider Business Practice Location Address
First Line	:	10814 HICKORY RIDGE RD
Second Line	:
City	:	COLUMBIA
State	:	MD
Zip	:	21044-3622
Country	:	US
Telephone Number	:	410-992-0011
Fax Number	:	410-992-1606

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/26/2006
Last Update Date	:	06/16/2011

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