MEDICARE: RONALD NORBERT TALAGA MD

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	149253-1	NY
2	207Q00000X	Family Medicine Physician	MD026395E	PA
3	207Q00000X	Family Medicine Physician	6145	AK

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	10421	OTHER	PA	GEISINGER HEALTH PLAN ID
2	MD026395E	OTHER	PA	MEDICAL LICENSE
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	002314	OTHER	PA	FIRST PRIORITY HEALTH ID
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	149253-1	OTHER	NY	STATE LICENSE
7	192196	OTHER	PA	BLUE SHIELD ID NUMBER

General Provider Information

NPI Number	:	1427099043
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RONALD NORBERT TALAGA MD

Provider Business Mailing Address
First Line	:	6000 KANAKANAK RD
Second Line	:	MEDICAL STAFF DEPARTMENT
City	:	DILLINGHAM
State	:	AK
Zip	:	99576-0130
Country	:	US
Telephone Number	:	907-842-5201
Fax Number	:	907-842-9250

Provider Business Practice Location Address
First Line	:	6000 KANAKANAK RD.
Second Line	:	MEDICAL STAFF DEPARTMENT
City	:	DILLINGHAM
State	:	AK
Zip	:	99576-0130
Country	:	US
Telephone Number	:	907-842-5201
Fax Number	:	907-842-9250

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

Provider Enumeration Date	:	06/08/2006
Last Update Date	:	04/23/2021

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