Healthcare Provider Details

I. General information

NPI: 1497755524
Provider Name (Legal Business Name): SALIHA ISHAQ MD
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 07/29/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9000 PATRICIA ST STE 209
CHALMETTE LA
70043-1791
US

IV. Provider business mailing address

PO BOX 409
CHALMETTE LA
70044-0409
US

V. Phone/Fax

Practice location:
  • Phone: 504-277-0124
  • Fax: 504-277-8006
Mailing address:
  • Phone: 504-277-0124
  • Fax: 504-279-8518

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number13304R
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: