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NPI Code Detail

MEDICARE: DHARAM GURWARA MD

MEDICARE: DHARAM GURWARA MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208100000XPhysical Medicine & Rehabilitation Physician017034LA
22084N0400XNeurology Physician017134LA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1689783342
Entity Type Code : Individual
Provider Name (Legal Business Name) : DHARAM GURWARA MD
Provider Business Mailing Address
First Line : PO BOX 5027
Second Line :
City : BOSSIER CITY
State : LA
Zip : 71171-5027
Country : US
Telephone Number : 318-686-5255
Fax Number : 318-752-2890
Provider Business Practice Location Address
First Line : 6821 PINES RD STE 400
Second Line :
City : SHREVEPORT
State : LA
Zip : 71129-2547
Country : US
Telephone Number : 318-686-5255
Fax Number : 318-686-5239
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/29/2006
Last Update Date : 04/09/2018

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Directions to “ DHARAM GURWARA MD” Practice Location

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