Healthcare Provider Details

I. General information

NPI: 1003270075
Provider Name (Legal Business Name): TALAL SEOUD MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/06/2016
Last Update Date: 01/16/2025
Certification Date: 01/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

272 HOSPITAL RD STE 225
CHILLICOTHEE OH
45601-9031
US

IV. Provider business mailing address

272 HOSPITAL RD STE 225
CHILLICOTHEE OH
45601-9031
US

V. Phone/Fax

Practice location:
  • Phone: 740-779-8530
  • Fax:
Mailing address:
  • Phone: 740-779-8530
  • Fax: 740-779-8539

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberME159586
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License NumberME159586
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number35.151658
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: