MEDICARE: DR. MANU BHARGAVA M.D., F.A.A.P.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician	13747R	LA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1053314187
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MANU BHARGAVA M.D., F.A.A.P.

Provider Business Mailing Address
First Line	:	6321 AUDUBON OAKS
Second Line	:
City	:	ALEXANDRIA
State	:	LA
Zip	:	71301-2798
Country	:	US
Telephone Number	:	318-767-2276
Fax Number	:

Provider Business Practice Location Address
First Line	:	101 MEDICAL PARK BLVD.
Second Line	:	SUITE A
City	:	PINEVILLE
State	:	LA
Zip	:	71360
Country	:	US
Telephone Number	:	318-561-0252
Fax Number	:	318-561-2454

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/23/2005
Last Update Date	:	03/25/2014

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