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Individual

MS. SHANMUGAN SHANTHA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
900 WILKINSON ST, MANDEVILLE, LA 70448-3533
(985) 624-4450
(985) 624-4451
Mailing address
7153 EDGEWATER DR, MANDEVILLE, LA 70471-7431
(504) 914-2908
(504) 349-1668

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
MD.15098R
LA
2084P0804X
Child & Adolescent Psychiatry Physician
MD150R
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1422029
LA
Enumeration date
08/08/2006
Last updated
01/31/2024
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