DR. TALAL IMAD MOUSALLEM M.D. NPI 1487812749

NPI Information

NPI: 1487812749
Provider Name: DR. TALAL IMAD MOUSALLEM, M.D.
Classification: Pediatrics - 2080P0201X
Entity Type: Individual

Specialization: Pediatric Allergy/Immunology

Organization: PRIVATE DIAGNOSTIC CLINIC, PLLC

PECOS Registration: Yes

Address:
MEDICAL CENTER BLVD
WINSTON SALEM, NC
ZIP 27157
Phone: (336) 716-2255
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DR. Talal Imad Mousallem, M.D. is a pediatric allergy/immunology pediatrics in Winston Salem, NC with 21 years of experience. The provider is a pediatrician who specializes in the diagnosis and treatment of allergies, allergic reactions, and immunologic diseases in children. DR. Talal Imad Mousallem, M.D. NPI is 1487812749. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

MEDICAL CENTER BLVD
WINSTON SALEM, NC
ZIP 27157-001
Phone: (336) 716-2255

The NPI 1487812749 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 5/22/2008 and was last updated on 12/18/2014.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207K00000X	Allergy & Immunology		2010-01468	NORTH CAROLINA	No
2	2080P0201X	Pediatrics	Pediatric Allergy/Immunology	2010-01468	NORTH CAROLINA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	1487812749	OTHER	VIRGINIA	VIRGINIA MEDICAID
2	Q0146O	OTHER	SOUTH CAROLINA	SC MEDICAID
3	NCG485A	MEDICARE PIN	NORTH CAROLINA
4	276230	OTHER	NORTH CAROLINA	MEDCOST
5	1487812749	MEDICAID	NORTH CAROLINA
6	1487812749	OTHER	NORTH CAROLINA	TRICARE
7	1846B	OTHER	NORTH CAROLINA	BCBS
8	3846320	OTHER	NORTH CAROLINA	UHC
9	4762627	OTHER	NORTH CAROLINA	AETNA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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