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General NPI Number Information
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NPI Number | 1417995168
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Entity Type | Organization
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Legal Business Name | MONROE CARDIOVASCULAR ASSOCIATES
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Dates
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Enumeration Date | 06/03/2006
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Last Update Date | 04/28/2008
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Provider Practice Location Address
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Address Line | 3100 FORSYTHE AVE
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City | MONROE
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State | LA
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Zip | 71201-3014
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Country | US
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Telephone | 318-699-0505
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Fax | 318-699-0506
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Provider Business Mailing Address
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Address Line | 3100 FORSYTHE AVE
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City | MONROE
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State | LA
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Zip | 71201-3014
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Country | US
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Telephone | 318-699-0505
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Fax | 318-699-0506
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Authorized Official
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Title or Position | PRACTICE MANAGER
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Name | SADIA QAMAR
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Credential | DR
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Telephone | 318-699-0505
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 12313R AND 12477R
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License Number State | LA
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