Individual
DR. LAUREEN TALTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
171 KEMPSVILLE RD, BUILDING B, NORFOLK, VA 23502-4700
(757) 668-6500
(757) 668-6522
Mailing address
171 KEMPSVILLE RD, BUILDING B, NORFOLK, VA 23502-4700
(757) 668-6500
(757) 668-6522
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
0101039464
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
006700870
VA PREMIER
—
05
—
006700870
—
VA
01
—
13029
OPTIMA
—
01
—
233009
MDIPA/MAMSI
—
01
—
330036
ANTHEM
—
01
—
541778786001
TRICARE
—
05
—
8906114
—
NC
Enumeration date
06/09/2006
Last updated
01/04/2013
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