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General NPI Number Information
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NPI Number | 1477737914
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Entity Type | Individual
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Provider Name | ADIL ARYAMAN FATAKIA M.D.
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Gender | Male
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Dates
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Enumeration Date | 12/19/2007
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Last Update Date | 05/29/2025
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Provider Practice Location Address
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Address Line | 1151 BARATARIA BLVD STE 3100
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City | MARRERO
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State | LA
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Zip | 70072-3083
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Country | US
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Telephone | 504-934-8461
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Fax | 504-371-3811
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Provider Business Mailing Address
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Address Line | 1151 BARATARIA BLVD STE 3100
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City | MARRERO
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State | LA
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Zip | 70072-3083
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Country | US
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Telephone | 504-934-8462
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Fax | 504-371-3811
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | PGY.1.TUL-OTO
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License Number State | LA
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Taxonomy #2
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | MD.203370
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License Number State | LA
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