Healthcare Provider Details

I. General information

NPI: 1831350016
Provider Name (Legal Business Name): SAIMAH TALUKDER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SAIMAH TALUKDER HUSSAIN MD

II. Dates (important events)

Enumeration Date: 06/20/2008
Last Update Date: 02/29/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1801 FAIRFIELD AVE SUITE 401
SHREVEPORT LA
71101-4443
US

IV. Provider business mailing address

1801 FAIRFIELD AVE SUITE 401
SHREVEPORT LA
71101-4443
US

V. Phone/Fax

Practice location:
  • Phone: 318-681-7728
  • Fax: 318-681-7729
Mailing address:
  • Phone: 318-681-7728
  • Fax: 318-681-7729

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207VX0000X
TaxonomyObstetrics Physician
License NumberMD.202866
License Number StateLA
# 2
Primary TaxonomyY
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License NumberMD.202866
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: