Provider Demographics
NPI:1417995168
Name:MONROE CARDIOVASCULAR ASSOCIATES
Entity Type:Organization
Organization Name:MONROE CARDIOVASCULAR ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SADIA
Authorized Official - Middle Name:
Authorized Official - Last Name:QAMAR
Authorized Official - Suffix:
Authorized Official - Credentials:DR
Authorized Official - Phone:318-699-0505
Mailing Address - Street 1:3100 FORSYTHE AVE
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:LA
Mailing Address - Zip Code:71201-3014
Mailing Address - Country:US
Mailing Address - Phone:318-699-0505
Mailing Address - Fax:318-699-0506
Practice Address - Street 1:3100 FORSYTHE AVE
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:LA
Practice Address - Zip Code:71201-3014
Practice Address - Country:US
Practice Address - Phone:318-699-0505
Practice Address - Fax:318-699-0506
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-03
Last Update Date:2008-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA12313R AND 12477R207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA4504036Medicaid
LA5C581Medicare PIN
LA5A854CMedicare UPIN