Healthcare Provider Details

I. General information

NPI: 1851520639
Provider Name (Legal Business Name): RABELAIS TATCHUM-TALOM MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: RABELEAIS TATCHUM-TALOM M.D.

II. Dates (important events)

Enumeration Date: 07/14/2009
Last Update Date: 09/15/2022
Certification Date: 09/15/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

508 S CHURCH ST HOSPITALIST OFFICE
MOUNT PLEASANT PA
15666-1702
US

IV. Provider business mailing address

508 S CHURCH ST HOSPITALIST OFFICE
MOUNT PLEASANT PA
15666-1702
US

V. Phone/Fax

Practice location:
  • Phone: 724-547-1500
  • Fax: 724-547-1762
Mailing address:
  • Phone: 724-547-1500
  • Fax: 724-547-1762

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207PE0004X
TaxonomyEmergency Medical Services (Emergency Medicine) Physician
License Number35.099963
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code281P00000X
TaxonomyChronic Disease Hospital
License NumberMD446786
License Number StatePA
# 3
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberMD446786
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: