Provider Demographics
NPI:1760451611
Name:TALREJA, DEEPAK ROSHAN (MD)
Entity Type:Individual
Prefix:DR
First Name:DEEPAK
Middle Name:ROSHAN
Last Name:TALREJA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1101 FIRST COLONIAL RD STE 300
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23454-2409
Mailing Address - Country:US
Mailing Address - Phone:757-395-1760
Mailing Address - Fax:
Practice Address - Street 1:1101 FIRST COLONIAL RD STE 300
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23454-2409
Practice Address - Country:US
Practice Address - Phone:757-395-1760
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-14
Last Update Date:2023-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101236598207RC0000X, 207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC89067K9Medicaid
VA165716OtherANTHEM
VAPAROtherUSA MANAGED CARE
VAPAROtherCORVEL/CORCARE
VAPAROtherAETNA
VA010072671Medicaid
VA15792OtherSENTARA OPTIMA
VAPAROtherVIRGINIA HEALTH NETWORK
VAPAROtherCIGNA
VAPAROtherVIRGINIA PREMIER HEALTH
VAPAROtherMULTIPLAN
VA-001OtherTRICARE/CHAMPUS
VA010133114Medicaid
NC067K9OtherBCBS
VA138462OtherANTHEM BCBS
VA75980OtherOPTIMA/SENTARA
9125500OtherUHC/MAMSI
VAPAROtherFIRST HEALTH COMMERCIAL/SOUTHERN HEALTH/COVENTRY
9125500OtherUHC/MAMSI
VAPAROtherFIRST HEALTH COMMERCIAL/SOUTHERN HEALTH/COVENTRY
VA010072671Medicaid
VA006701E30Medicare PIN
VA-001OtherTRICARE/CHAMPUS
VAH15438Medicare UPIN