Individual
DR. MAHMOUD DAFTARY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2750 GAUSE BLVD. EAST, SLIDELL, LA 70461
(985) 639-3777
Mailing address
1514 JEFFERSON HIGHWAY, NEW ORLEANS, LA 70121
(504) 842-4000
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
04535R
LA
208800000X
Urology Physician
Primary
MD.04535R
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00122909
—
MS
05
—
1329444
—
LA
01
—
P00396221
RAILROAD MEDICARE
LA
Enumeration date
07/19/2005
Last updated
11/19/2009
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