Provider Demographics
NPI:1871631002
Name:TALWALKAR, SAMEER S (MD)
Entity Type:Individual
Prefix:DR
First Name:SAMEER
Middle Name:S
Last Name:TALWALKAR
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 1:1255 W WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85281-1210
Mailing Address - Country:US
Mailing Address - Phone:602-685-5211
Mailing Address - Fax:602-685-5325
Practice Address - Street 1:1255 W WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85281-1210
Practice Address - Country:US
Practice Address - Phone:602-685-5211
Practice Address - Fax:602-685-5325
Is Sole Proprietor?:No
Enumeration Date:2007-02-01
Last Update Date:2020-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ59536207ZH0000X, 207ZP0102X
KY41547207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
No207ZH0000XAllopathic & Osteopathic PhysiciansPathologyHematology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ59536OtherARIZONA MEDICAL BOARD