Healthcare Provider Details

I. General information

NPI: 1215519962
Provider Name (Legal Business Name): SANNA MOHAMMAD MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/22/2021
Last Update Date: 10/25/2024
Certification Date: 10/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 METAIRIE RD
METAIRIE LA
70005-4043
US

IV. Provider business mailing address

800 METAIRIE RD
METAIRIE LA
70005-4043
US

V. Phone/Fax

Practice location:
  • Phone: 504-703-7740
  • Fax:
Mailing address:
  • Phone: 504-703-7740
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number344320
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: