Provider Demographics
NPI:1225345085
Name:ASAD, ANJUM (MD)
Entity Type:Individual
Prefix:
First Name:ANJUM
Middle Name:
Last Name:ASAD
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 1:5000 AMBASSADOR CAFFERY PKWY
Mailing Address - Street 2:SUITE 6 B
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70508-6984
Mailing Address - Country:US
Mailing Address - Phone:337-470-3070
Mailing Address - Fax:337-470-2318
Practice Address - Street 1:1516 CHEMIN METAIRIE RD STE A
Practice Address - Street 2:
Practice Address - City:YOUNGSVILLE
Practice Address - State:LA
Practice Address - Zip Code:70592-2000
Practice Address - Country:US
Practice Address - Phone:337-857-5910
Practice Address - Fax:337-857-5913
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-31
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA206557207R00000X
LAMD.206557207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA2119532Medicaid