Provider Demographics
NPI:1619987997
Name:WALVEKAR, ROHAN R (MD)
Entity Type:Individual
Prefix:DR
First Name:ROHAN
Middle Name:R
Last Name:WALVEKAR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:533 BOLIVAR ST STE 566
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70112-1349
Mailing Address - Country:US
Mailing Address - Phone:504-568-4785
Mailing Address - Fax:
Practice Address - Street 1:533 BOLIVAR ST STE 566
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70112-1349
Practice Address - Country:US
Practice Address - Phone:504-568-4785
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-09
Last Update Date:2021-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PALT000592207Y00000X
LAMD.203050207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1103845Medicaid
LAI50929Medicare UPIN
LA4M326CW42Medicare PIN