Healthcare Provider Details

I. General information

NPI: 1205389996
Provider Name (Legal Business Name): ADARSH VIJAY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/28/2016
Last Update Date: 10/17/2023
Certification Date: 10/17/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1415 TULANE AVE # HC -05
NEW ORLEANS LA
70112-2600
US

IV. Provider business mailing address

1415 TULANE AVE # HC -05
NEW ORLEANS LA
70112-2600
US

V. Phone/Fax

Practice location:
  • Phone: 504-988-5263
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code204F00000X
TaxonomyTransplant Surgery Physician
License Number241174
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code204F00000X
TaxonomyTransplant Surgery Physician
License Number322034
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: