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General NPI Number Information
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NPI Number | 1831184407
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Entity Type | Individual
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Provider Name | MARWAN KASKAS MD
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Gender | Male
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Dates
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Enumeration Date | 09/20/2005
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Last Update Date | 07/01/2010
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Provider Practice Location Address
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Address Line | 2501 GREENWOOD RD
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City | SHREVEPORT
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State | LA
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Zip | 71103-3905
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Country | US
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Telephone | 318-631-1584
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Fax | 318-635-8322
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Provider Business Mailing Address
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Address Line | 1800 BUCKNER ST SUITE C120
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City | SHREVEPORT
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State | LA
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Zip | 71101-4440
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Country | US
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Telephone | 318-227-8899
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Fax | 318-222-0407
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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 | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number | 09084R
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License Number State | LA
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