Healthcare Provider Details

I. General information

NPI: 1275642837
Provider Name (Legal Business Name): RAJESH MOHANDAS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/29/2006
Last Update Date: 04/19/2022
Certification Date: 04/19/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 CANAL ST
NEW ORLEANS LA
70112-3018
US

IV. Provider business mailing address

1542 TULANE AVE RM 330A
NEW ORLEANS LA
70112-2865
US

V. Phone/Fax

Practice location:
  • Phone: 504-702-3000
  • Fax:
Mailing address:
  • Phone: 504-568-8824
  • Fax: 504-568-2127

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RG0300X
TaxonomyGeriatric Medicine (Internal Medicine) Physician
License Number01051517A
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License NumberME110022
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number329445
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: