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General NPI Number Information
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NPI Number | 1649378985
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Entity Type | Individual
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Provider Name | USHA PADMAMA MANDHARE MD
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Gender | Female
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Dates
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Enumeration Date | 09/20/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 501 RUE DE SANTE STE 10
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City | LA PLACE
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State | LA
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Zip | 70068-5400
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Country | US
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Telephone | 985-652-8413
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Fax | 985-651-9702
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Provider Business Mailing Address
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Address Line | 550 LOWERLINE ST
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City | NEW ORLEANS
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State | LA
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Zip | 70118-3860
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Country | US
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Telephone | 504-957-0595
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Fax |
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 025751
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License Number State | LA
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