Individual
VENKAT TALASILA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2578 MCLEOD DR N STE 1, SAGINAW, MI 48604-2859
(989) 799-5440
(989) 799-5651
Mailing address
2578 MCLEOD DR N, STE 1, SAGINAW, MI 48604-2859
(989) 799-5440
(989) 799-5651
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
4301407245
MI
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
4301407245
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1942468459
—
MI
05
—
3117160
—
MI
Enumeration date
08/10/2005
Last updated
07/23/2021
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