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General NPI Number Information
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NPI Number | 1790722155
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Entity Type | Individual
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Provider Name | GEORGE S TALIADOUROS MD
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Gender | Male
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Dates
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Enumeration Date | 06/02/2006
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Last Update Date | 12/18/2024
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Provider Practice Location Address
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Address Line | 405 HURFFVILLE CROSSKEYS RD STE 202
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City | SEWELL
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State | NJ
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Zip | 08080-9344
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Country | US
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Telephone | 856-589-1414
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Fax | 856-256-5772
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Provider Business Mailing Address
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Address Line | 405 HURFFVILLE CROSSKEYS RD STE 202
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City | SEWELL
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State | NJ
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Zip | 08080-9344
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Country | US
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Telephone | 856-589-1414
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Fax | 856-256-5772
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207VG0400X
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Taxonomy Name | Gynecology Physician
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License Number | 25MA05209100
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 207VE0102X
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Taxonomy Name | Reproductive Endocrinology Physician
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License Number | MA52091
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License Number State | NJ
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