Individual
BASAVALINGA SWAMY TALUR MATADHA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3636 HIGH ST, PORTSMOUTH, VA 23707-3236
(757) 398-2280
Mailing address
3636 HIGH ST, PORTSMOUTH, VA 23707-3236
(757) 398-2280
Taxonomy
Speciality
Code
Description
License number
State
208M00000X
Hospitalist Physician
Primary
0101245352
VA
Other
Enumeration date
07/17/2007
Last updated
12/21/2012
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