Provider Demographics
NPI:1295262665
Name:NADIMPALLY, UDAY SHANKER
Entity type:Individual
Prefix:
First Name:UDAY SHANKER
Middle Name:
Last Name:NADIMPALLY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:UDAY SANKER
Other - Middle Name:
Other - Last Name:NADIMPALLY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1514 JEFFERSON HWY
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70121-2429
Mailing Address - Country:US
Mailing Address - Phone:504-842-4000
Mailing Address - Fax:
Practice Address - Street 1:2820 NAPOLEON AVE
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70115-6969
Practice Address - Country:US
Practice Address - Phone:504-894-2700
Practice Address - Fax:504-842-3157
Is Sole Proprietor?:No
Enumeration Date:2017-05-17
Last Update Date:2022-11-21
Deactivation Date:2017-12-18
Deactivation Code:
Reactivation Date:2018-05-12
Provider Licenses
StateLicense IDTaxonomies
390200000X
LA3339812084V0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084V0102XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyVascular Neurology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program