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Contact Information

SREYA TALASILA, MD
3190 LANCER ST
PORTAGE, IN46368-4488
 Phone: 219-764-3600
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

MOHS-Micrographic Surgery

207ND0101X 07 Physician/Dermatology
 

Dermatology

207N00000X 07 Physician/Dermatology
Indicates primary specialty

NPI Profile & details for SREYA TALASILA · (Female)

NPI # 1366860884
Status Active
Credentials MD
Entity Individual
Enumeration date 04/01/2014
Last updated 07/25/2021 - About 5 years ago
Sole proprietor 1 No
Identifiers
  • IL License # 036.146276
  • IN License # 01085876A
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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