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NPI Code Detail

MEDICARE: DR. MANISH DHAWAN MD

MEDICARE: DR. MANISH DHAWAN MD
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
1207RH0003XHematology & Oncology Physician11219RLA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1083618912
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MANISH DHAWAN MD
Provider Business Mailing Address
First Line : PO BOX 4506
Second Line :
City : SHREVEPORT
State : LA
Zip : 71134-0506
Country : US
Telephone Number : 318-239-4860
Fax Number : 318-588-8820
Provider Business Practice Location Address
First Line : 10600 INDUSTRIAL DR
Second Line :
City : MINDEN
State : LA
Zip : 71055-5105
Country : US
Telephone Number : 318-239-4860
Fax Number : 318-588-8820
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/09/2005
Last Update Date : 07/22/2022

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Directions to “ DR. MANISH DHAWAN MD” Practice Location

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