Provider Demographics
NPI:1770501447
Name:ALAM, IRFAN
Entity Type:Individual
Prefix:DR
First Name:IRFAN
Middle Name:
Last Name:ALAM
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4212 W CONGRESS ST
Mailing Address - Street 2:SUITE 2400E
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70506-6765
Mailing Address - Country:US
Mailing Address - Phone:337-984-4350
Mailing Address - Fax:337-984-4351
Practice Address - Street 1:4212 W CONGRESS ST
Practice Address - Street 2:SUITE 2400E
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70506-6765
Practice Address - Country:US
Practice Address - Phone:337-984-4350
Practice Address - Fax:337-984-4351
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-18
Last Update Date:2013-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAMD 11659R207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology