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General NPI Number Information
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NPI Number | 1497577837
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Entity Type | Organization
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Legal Business Name | CENTER FOR DIABETES AND WELLNESS LLC
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Dates
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Enumeration Date | 10/28/2024
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Last Update Date | 10/28/2024
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Provider Practice Location Address
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Address Line | 3212 S 110 SERVICE RD W SUITE A
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City | METAIRIE
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State | LA
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Zip | 70001-7006
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Country | US
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Telephone | 504-766-9758
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Fax | 985-781-4319
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Provider Business Mailing Address
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Address Line | 99 PALMETTO
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City | KENNER
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State | LA
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Zip | 70065-6826
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Country | US
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Telephone | 251-716-4428
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Fax | 985-781-4319
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Authorized Official
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Title or Position | MD
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Name | DR. ABDUL MANNAH KHAN
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Credential | MD
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Telephone | 504-766-9758
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number |
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License Number State |
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