Provider Demographics
NPI:1639188923
Name:DR WADHWA & DR OBEROI LLC
Entity Type:Organization
Organization Name:DR WADHWA & DR OBEROI LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:AJAY
Authorized Official - Middle Name:K
Authorized Official - Last Name:WADHWA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:985-651-9293
Mailing Address - Street 1:PO BOX 1450
Mailing Address - Street 2:
Mailing Address - City:LA PLACE
Mailing Address - State:LA
Mailing Address - Zip Code:70069-1450
Mailing Address - Country:US
Mailing Address - Phone:985-651-9293
Mailing Address - Fax:985-651-9292
Practice Address - Street 1:148 WOODLAND DR
Practice Address - Street 2:
Practice Address - City:LA PLACE
Practice Address - State:LA
Practice Address - Zip Code:70068-5939
Practice Address - Country:US
Practice Address - Phone:985-651-9293
Practice Address - Fax:985-651-9292
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-05
Last Update Date:2008-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1441422Medicaid
LA5C875Medicare ID - Type UnspecifiedMEDICARE GROUP #