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NPI Code Detail

MEDICARE: DR. MARWAN KASKAS MD

MEDICARE:  DR. MARWAN  KASKAS  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
1207RN0300XNephrology Physician09084RLA

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1390005504OTHERLARAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2721404303KA1OTHEROCHSNER
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
53100063OTHERUNITED HEALTHCARE
6A004OTHERLACHAMPUS

General Provider Information

NPI Number : 1831184407
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MARWAN KASKAS MD
Provider Business Mailing Address
First Line : 1800 BUCKNER ST
Second Line : SUITE C120
City : SHREVEPORT
State : LA
Zip : 71101-4440
Country : US
Telephone Number : 318-227-8899
Fax Number : 318-222-0407
Provider Business Practice Location Address
First Line : 2501 GREENWOOD RD
Second Line :
City : SHREVEPORT
State : LA
Zip : 71103-3905
Country : US
Telephone Number : 318-631-1584
Fax Number : 318-635-8322
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/20/2005
Last Update Date : 07/01/2010

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Directions to “ DR. MARWAN KASKAS MD” Practice Location

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