Organization
WAGIH MANDO, M.D., FACS., LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WAGIH R MANDO MD (PRESIDENT)
(504) 464-8619
Entity
Organization
Contact information
Practice address
200 W ESPLANADE AVE, SUITE 410, KENNER, LA 70065-2489
(504) 464-8619
Mailing address
200 W ESPLANADE AVE, SUITE 410, KENNER, LA 70065-2489
(504) 464-8619
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1966312
—
LA
Enumeration date
01/31/2008
Last updated
01/31/2008
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