Provider Demographics
NPI:1285678417
Name:TAYAL, SUDESH (MD)
Entity Type:Individual
Prefix:DR
First Name:SUDESH
Middle Name:
Last Name:TAYAL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 WILD PARTRIDGE LN
Mailing Address - Street 2:
Mailing Address - City:RADFORD
Mailing Address - State:VA
Mailing Address - Zip Code:24141-4210
Mailing Address - Country:US
Mailing Address - Phone:540-639-0035
Mailing Address - Fax:
Practice Address - Street 1:128 JEFFERSON ST
Practice Address - Street 2:WALDRON HALL - RADFORD UNIVERSITY CLINICS
Practice Address - City:RADFORD
Practice Address - State:VA
Practice Address - Zip Code:24142
Practice Address - Country:US
Practice Address - Phone:540-831-7660
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101032804207QA0505X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine