Provider Demographics
NPI:1346297553
Name:SARCAR, MANASH K (MD)
Entity Type:Individual
Prefix:
First Name:MANASH
Middle Name:K
Last Name:SARCAR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:926 DELAWARE ST
Mailing Address - Street 2:
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71106-1504
Mailing Address - Country:US
Mailing Address - Phone:318-453-7682
Mailing Address - Fax:918-664-6120
Practice Address - Street 1:4500 S GARNETT RD
Practice Address - Street 2:SUITE 300
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74146-5229
Practice Address - Country:US
Practice Address - Phone:918-392-2944
Practice Address - Fax:918-664-2521
Is Sole Proprietor?:No
Enumeration Date:2006-05-31
Last Update Date:2013-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAMD0171822085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1369870Medicaid
LAB64668Medicare UPIN
LA1369870Medicaid