Provider Demographics
NPI:1043391444
Name:SHAMEEM AKHTAR, MD APMC
Entity Type:Organization
Organization Name:SHAMEEM AKHTAR, MD APMC
Other - Org Name:SHAMEEM AKHTAR
Other - Org Type:Doing Business As
Authorized Official - Title/Position:M.D.
Authorized Official - Prefix:DR
Authorized Official - First Name:SHAMEEM
Authorized Official - Middle Name:
Authorized Official - Last Name:AKHTAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:337-406-9000
Mailing Address - Street 1:101 POMEROL PL
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70503-6515
Mailing Address - Country:US
Mailing Address - Phone:337-988-9911
Mailing Address - Fax:
Practice Address - Street 1:4640 W CONGRESS ST
Practice Address - Street 2:SUIT A
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70506-6602
Practice Address - Country:US
Practice Address - Phone:337-406-9000
Practice Address - Fax:337-991-0140
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-18
Last Update Date:2011-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAMD201062207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty