Individual
DR. BAHMAN ABRAHAM DANESHFAR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
302 ARABELLA BLVD, LAFAYETTE, LA 70508-6054
(337) 593-7285
Mailing address
302 ARABELLA BLVD, LAFAYETTE, LA 70508-6054
(337) 593-7285
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
09493R
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
09493R
LICENSE
LA
05
—
1957402
—
LA
01
—
721255624
TAX ID
—
01
—
920000960
RAILROAD MEDICARE
—
Enumeration date
03/28/2006
Last updated
12/01/2016
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