Individual
DR. LARISA I ALLAKHVERDOVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1225 E COOLSPRING AVE, MICHIGAN CITY, IN 46360-6312
(219) 873-2919
Mailing address
200 CORPORATE BLVD, LAFAYETTE, LA 70508-3870
(800) 893-9698
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
01057834A
IN
207P00000X
Emergency Medicine Physician
228819
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02844177
—
NY
05
—
200805060
—
IN
01
—
M47140293
MEDICARE
IN
01
—
P01186413
MEDICARE RAILROAD
KY
Enumeration date
10/13/2005
Last updated
03/27/2018
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