Provider Demographics
NPI:1184657314
Name:ARA, ANJUMAN - (MD)
Entity Type:Individual
Prefix:
First Name:ANJUMAN
Middle Name:-
Last Name:ARA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 W ESPLANADE AVE STE 312
Mailing Address - Street 2:
Mailing Address - City:KENNER
Mailing Address - State:LA
Mailing Address - Zip Code:70065-2474
Mailing Address - Country:US
Mailing Address - Phone:504-712-8872
Mailing Address - Fax:504-712-8879
Practice Address - Street 1:200 W ESPLANADE AVE STE 312
Practice Address - Street 2:
Practice Address - City:KENNER
Practice Address - State:LA
Practice Address - Zip Code:70065-2474
Practice Address - Country:US
Practice Address - Phone:504-712-8872
Practice Address - Fax:504-712-8879
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA14086R207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine