Provider Demographics
NPI:1649378985
Name:MANDHARE, USHA PADMAMA (MD)
Entity Type:Individual
Prefix:DR
First Name:USHA
Middle Name:PADMAMA
Last Name:MANDHARE
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 1:550 LOWERLINE ST
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70118-3860
Mailing Address - Country:US
Mailing Address - Phone:504-957-0595
Mailing Address - Fax:
Practice Address - Street 1:501 RUE DE SANTE STE 10
Practice Address - Street 2:
Practice Address - City:LA PLACE
Practice Address - State:LA
Practice Address - Zip Code:70068-5400
Practice Address - Country:US
Practice Address - Phone:985-652-8413
Practice Address - Fax:985-651-9702
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA025751207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine