Provider Demographics
NPI:1679885362
Name:SHIRSAT, PALLAVI (MD)
Entity Type:Individual
Prefix:
First Name:PALLAVI
Middle Name:
Last Name:SHIRSAT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:102 MONROE STREET
Mailing Address - Street 2:SUITE B
Mailing Address - City:MINDEN
Mailing Address - State:LA
Mailing Address - Zip Code:71055-3357
Mailing Address - Country:US
Mailing Address - Phone:318-377-7290
Mailing Address - Fax:318-377-7290
Practice Address - Street 1:102 MONROE STREET
Practice Address - Street 2:SUITE B
Practice Address - City:MINDEN
Practice Address - State:LA
Practice Address - Zip Code:71055-3357
Practice Address - Country:US
Practice Address - Phone:318-377-7290
Practice Address - Fax:318-377-7290
Is Sole Proprietor?:No
Enumeration Date:2010-07-09
Last Update Date:2017-03-14
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
LAMD.207150207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology