Provider Demographics
NPI:1902823966
Name:BAHNA, SAMI LABIB (MD)
Entity Type:Individual
Prefix:
First Name:SAMI
Middle Name:LABIB
Last Name:BAHNA
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1501 KINGS HWY
Mailing Address - Street 2:DEPARTMENT OF PEDIATRIC, SECTION OF ALLERGY & IMMUNOLOG
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71103-4228
Mailing Address - Country:US
Mailing Address - Phone:318-675-8601
Mailing Address - Fax:318-675-8872
Practice Address - Street 1:1501 KINGS HWY
Practice Address - Street 2:DEPARTMENT OF PEDIATRIC, SECTION OF ALLERGY & IMMUNOLOG
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71103-4228
Practice Address - Country:US
Practice Address - Phone:318-675-8601
Practice Address - Fax:318-675-8872
Is Sole Proprietor?:No
Enumeration Date:2006-07-16
Last Update Date:2009-07-31
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Provider Licenses
StateLicense IDTaxonomies
LA04267R2080P0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0201XAllopathic & Osteopathic PhysiciansPediatricsPediatric Allergy/Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1185736Medicaid
LA1185736Medicaid
LA4E276F600Medicare ID - Type Unspecified