Healthcare Provider Details

I. General information

NPI: 1396306932
Provider Name (Legal Business Name): LANA Y ABUSALEM MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/25/2019
Last Update Date: 08/27/2026
Certification Date: 08/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

155 HOSPITAL DR
LAFAYETTE LA
70503-2852
US

IV. Provider business mailing address

155 HOSPITAL DR
LAFAYETTE LA
70503-2852
US

V. Phone/Fax

Practice location:
  • Phone: 501-686-5162
  • Fax:
Mailing address:
  • Phone: 501-686-7592
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License Number351940
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: