Healthcare Provider Details
I. General information
NPI: 1356760995
Provider Name (Legal Business Name): TALAL AKHTER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 04/10/2014
Last Update Date: 04/02/2024
Certification Date: 04/02/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1 AKRON GENERAL AVE
AKRON OH
44307-2432
US
IV. Provider business mailing address
2647 BALLYDOYLE DR
SPRINGFIELD OH
45503-1171
US
V. Phone/Fax
- Phone: 330-344-6000
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2085R0202X |
| Taxonomy | Diagnostic Radiology Physician |
| License Number | 036153416 |
| License Number State | IL |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2085R0204X |
| Taxonomy | Vascular & Interventional Radiology Physician |
| License Number | 036153416 |
| License Number State | IL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: