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General NPI Number Information
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NPI Number | 1316133051
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Entity Type | Organization
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Legal Business Name | DHAYA N. KUTNIKAR M.D. APMC
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Dates
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Enumeration Date | 09/17/2007
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Last Update Date | 07/31/2024
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Provider Practice Location Address
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Address Line | 1805 LAMY LN
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City | MONROE
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State | LA
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Zip | 71201-3739
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Country | US
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Telephone | 318-388-5383
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Fax | 318-388-5779
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Provider Business Mailing Address
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Address Line | 1805 LAMY LN
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City | MONROE
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State | LA
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Zip | 71201-3739
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Country | US
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Telephone | 318-388-5383
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Fax | 318-388-5779
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Authorized Official
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Title or Position | OWNER
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Name | MRS. DHAYA N KUTNIKAR
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Credential | M.D.
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Telephone | 318-388-5383
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 173000000X
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Taxonomy Name | Legal Medicine
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License Number | 018722
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License Number State | LA
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Taxonomy #2
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Taxonomy Code | 173000000X
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Taxonomy Name | Legal Medicine
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License Number | 023401
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License Number State | LA
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