Individual
DR. WAGIH R MANDO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D
Contact information
Practice address
200 W ESPLANADE AVE, SUITE 410, KENNER, LA 70065-2489
(504) 464-8619
(504) 464-4876
Mailing address
200 W ESPLANADE AVE, SUITE 410, KENNER, LA 70065-2489
(504) 464-8619
(504) 464-4876
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
09630R
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1966312
—
LA
Enumeration date
04/03/2006
Last updated
04/13/2011
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