Basic Information
| Provider Information | |||||||||
| NPI: | 1407296676 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GAIGE | ||||||||
| FirstName: | TASHA | ||||||||
| MiddleName: | RUTH | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 13856 N DALE MABRY HWY | ||||||||
| Address2: | |||||||||
| City: | TAMPA | ||||||||
| State: | FL | ||||||||
| PostalCode: | 336182420 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3042433880 | ||||||||
| FaxNumber: | 8132641885 | ||||||||
| Practice Location | |||||||||
| Address1: | 40 MEDICAL PARK | ||||||||
| Address2: | SUITE 401 | ||||||||
| City: | WHEELING | ||||||||
| State: | WV | ||||||||
| PostalCode: | 26003 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3042433880 | ||||||||
| FaxNumber: | 3042433895 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/02/2013 | ||||||||
| LastUpdateDate: | 05/18/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 207Q00000X | ME113548 | FL | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.