Individual
LEONARD MICHAEL TALARICO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
140 TRADERS WAY, POOLER, GA 31322-4035
(912) 330-8885
(912) 330-8858
Mailing address
140 TRADERS WAY, POOLER, GA 31322-4035
(912) 330-8885
(912) 330-8858
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
945
GA
213ES0103X
Foot & Ankle Surgery Podiatrist
945
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000233650702
UNITED HEALTHCARE
GA
05
—
10071146
—
GA
05
—
370807
—
GA
01
—
48SCCVD
MEDICARE
GA
01
—
4955111
CIGNA
GA
01
—
52053396005
BLUE CROSS BLUE SHIELD
GA
05
—
953027052D
—
GA
01
—
DF3241
MEDICARE RAILROAD GROUP NUMBER
GA
01
—
P00355897
RAILROAD MEDICARE PIN
GA
Enumeration date
08/02/2006
Last updated
02/12/2022
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