Provider Demographics
NPI:1427099043
Name:TALAGA, RONALD NORBERT (MD)
Entity type:Individual
Prefix:
First Name:RONALD
Middle Name:NORBERT
Last Name:TALAGA
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 1:6000 KANAKANAK RD
Mailing Address - Street 2:MEDICAL STAFF DEPARTMENT
Mailing Address - City:DILLINGHAM
Mailing Address - State:AK
Mailing Address - Zip Code:99576-0130
Mailing Address - Country:US
Mailing Address - Phone:907-842-5201
Mailing Address - Fax:907-842-9250
Practice Address - Street 1:6000 KANAKANAK RD.
Practice Address - Street 2:MEDICAL STAFF DEPARTMENT
Practice Address - City:DILLINGHAM
Practice Address - State:AK
Practice Address - Zip Code:99576-0130
Practice Address - Country:US
Practice Address - Phone:907-842-5201
Practice Address - Fax:907-842-9250
Is Sole Proprietor?:No
Enumeration Date:2006-06-08
Last Update Date:2021-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY149253-1207Q00000X
PAMD026395E207Q00000X
AK6145207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA10421OtherGEISINGER HEALTH PLAN ID
PAMD026395EOtherMEDICAL LICENSE
PA000839813Medicaid
PA002314OtherFIRST PRIORITY HEALTH ID
NY00701280Medicaid
NY149253-1OtherSTATE LICENSE
PA192196OtherBLUE SHIELD ID NUMBER
AK8EJ535Medicare UPIN
AK8EI290Medicare UPIN
AK8EJ519Medicare UPIN
PAMD026395EOtherMEDICAL LICENSE
PA000839813Medicaid
NY149253-1OtherSTATE LICENSE
AK8EJ664Medicare UPIN
AK8EJ533Medicare UPIN
AK8EJ517Medicare UPIN
PA192196OtherBLUE SHIELD ID NUMBER
AK8EF336Medicare UPIN
AK8EJ520Medicare UPIN
AK8EJ521Medicare UPIN
AK8EJ518Medicare UPIN
AK8EJ516Medicare UPIN
AK8EJ522Medicare UPIN
NY9X6731Medicare ID - Type Unspecified
PA192196Medicare ID - Type Unspecified