Provider Demographics
NPI:1982666103
Name:ASBAHI, MOHAMED BADI SALAHI (MD)
Entity Type:Individual
Prefix:
First Name:MOHAMED
Middle Name:BADI SALAHI
Last Name:ASBAHI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:MOHAMAD
Other - Middle Name:
Other - Last Name:ASBAHI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:303 VETERANS BLVD
Mailing Address - Street 2:STE C
Mailing Address - City:DENHAM SPRINGS
Mailing Address - State:LA
Mailing Address - Zip Code:70726
Mailing Address - Country:US
Mailing Address - Phone:225-664-8010
Mailing Address - Fax:225-664-8012
Practice Address - Street 1:303 VETERANS BLVD
Practice Address - Street 2:STE C
Practice Address - City:DENHAM SPRINGS
Practice Address - State:LA
Practice Address - Zip Code:70726
Practice Address - Country:US
Practice Address - Phone:225-664-8010
Practice Address - Fax:225-664-8012
Is Sole Proprietor?:No
Enumeration Date:2006-04-04
Last Update Date:2021-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAMD04169R208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1182192Medicaid
LA1182192Medicaid