Healthcare Provider Details

I. General information

NPI: 1518959782
Provider Name (Legal Business Name): JAMES MICHAEL TALAMO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/15/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

529 RUGH ST
GREENSBURG PA
15601-5615
US

IV. Provider business mailing address

529 RUGH ST
GREENSBURG PA
15601-5615
US

V. Phone/Fax

Practice location:
  • Phone: 724-837-2550
  • Fax:
Mailing address:
  • Phone: 724-837-2550
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMD026093-E
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: