# VENKAT TALASILA

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1124029335
- **Gender:** Man
- **Credential:** M.D.

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 174400000X | Specialist | 4301407245 | MI | — |
| 2084P0804X | Child & Adolescent Psychiatry Physician | 4301407245 | MI | Yes |

## Other

- **Enumeration date:** 08/10/2005
- **Last updated:** 07/23/2021

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1942468459 | — | MI |
| 05 | — | 3117160 | — | MI |