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NPI Code Detail

MEDICARE: KHYATI APOORVA TALATI MD

MEDICARE: KHYATI APOORVA TALATI MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208M00000XHospitalist Physician036141546IL
2207Q00000XFamily Medicine Physician0101265551VA
3207Q00000XFamily Medicine Physician125065653IL

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1214881OTHERILMEDICARE GROUP PTAN

General Provider Information

NPI Number : 1134534167
Entity Type Code : Individual
Provider Name (Legal Business Name) : KHYATI APOORVA TALATI MD
Provider Business Mailing Address
First Line : PO BOX 7068
Second Line :
City : PORTSMOUTH
State : VA
Zip : 23707-0068
Country : US
Telephone Number : 757-686-3516
Fax Number : 757-686-0230
Provider Business Practice Location Address
First Line : 2203 E LITTLE CREEK RD
Second Line :
City : NORFOLK
State : VA
Zip : 23518-4205
Country : US
Telephone Number : 757-583-2181
Fax Number : 757-480-6482
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/28/2014
Last Update Date : 07/13/2024

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