Individual
RAJA S TALLURI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
22080 LA HWY 20, VACHERIE, LA 70090
(225) 265-3061
(225) 265-3062
Mailing address
P.O. BOX 69, VACHERIE, LA 70090
(225) 265-3061
(225) 265-3062
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
12874R
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1549029
—
LA
Enumeration date
04/12/2006
Last updated
04/15/2009
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