Provider Demographics
NPI:1801872627
Name:WAHID, DARAKHSHAN (MD)
Entity type:Individual
Prefix:
First Name:DARAKHSHAN
Middle Name:
Last Name:WAHID
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:8490 PICARDY AVE
Mailing Address - Street 2:BLDG 200
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70809-3731
Mailing Address - Country:US
Mailing Address - Phone:225-237-1754
Mailing Address - Fax:225-237-1722
Practice Address - Street 1:3401 NORTH BLVD
Practice Address - Street 2:STE 130
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70806
Practice Address - Country:US
Practice Address - Phone:225-381-2727
Practice Address - Fax:225-381-2753
Is Sole Proprietor?:No
Enumeration Date:2005-12-22
Last Update Date:2014-09-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
LA11841R207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA110231258OtherRAILROAD MEDICARE
LA1681971Medicaid
LA5W822CB97Medicare PIN
LA110231258OtherRAILROAD MEDICARE