Provider Demographics
NPI:1497577837
Name:CENTER FOR DIABETES AND WELLNESS LLC
Entity type:Organization
Organization Name:CENTER FOR DIABETES AND WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:DR
Authorized Official - First Name:ABDUL
Authorized Official - Middle Name:MANNAH
Authorized Official - Last Name:KHAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:504-766-9758
Mailing Address - Street 1:99 PALMETTO
Mailing Address - Street 2:
Mailing Address - City:KENNER
Mailing Address - State:LA
Mailing Address - Zip Code:70065-6826
Mailing Address - Country:US
Mailing Address - Phone:251-716-4428
Mailing Address - Fax:985-781-4319
Practice Address - Street 1:3212 S 110 SERVICE RD W
Practice Address - Street 2:SUITE A
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70001-7006
Practice Address - Country:US
Practice Address - Phone:504-766-9758
Practice Address - Fax:985-781-4319
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-28
Last Update Date:2024-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Single Specialty