Provider Demographics
NPI:1043428113
Name:TAGLIAFERRI, MARGIT C (MD)
Entity type:Individual
Prefix:
First Name:MARGIT
Middle Name:C
Last Name:TAGLIAFERRI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MARGIT
Other - Middle Name:C
Other - Last Name:DIJKSTRA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 26170
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94126-6170
Mailing Address - Country:US
Mailing Address - Phone:415-658-6791
Mailing Address - Fax:415-520-0904
Practice Address - Street 1:201 SPEAR ST
Practice Address - Street 2:SUITE 230
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94105-1630
Practice Address - Country:US
Practice Address - Phone:415-503-9277
Practice Address - Fax:415-291-0489
Is Sole Proprietor?:No
Enumeration Date:2007-05-20
Last Update Date:2012-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH57008562208D00000X
CAA113641207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH3600017Medicaid
OH3600017Medicaid