Haiderzad, Talia E

Haiderzad, Talia E is an individual health care provider with primary practice located at 3001 Warrior Ln , Poplar Bluff MO 63901-8685. She recently has only one registered license in Allopathic & Osteopathic Physicians / Psychiatry, which is considered as her primary health care specialty. Haiderzad, Talia E can be contacted via phone (573) 686-1200.

Contact Information

Primary practice address
3001 Warrior Ln Poplar Bluff MO 63901-8685
Phone: (573) 686-1200
Fax: (573) 686-1029
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X M103571 Missouri

Profile Details

NPI number 1669572871
LBN Legal business name Haiderzad, Talia E
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 25th, 2006
Last updated Jan 21st, 2009 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1669572871 NPPES
Other 255217 VALUE OPTIONS
MEDICAID 146412001 VALUE OPTIONS
MEDICAID 208103432 VALUE OPTIONS
Other 11060304 VALUE OPTIONS

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