Organization
PANDYA INTERNAL MEDICINE CLINIC, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MAHESH PANDYA M.D. (DIRECTOR)
(337) 463-2172
Entity
Organization
Contact information
Practice address
603 S PINE ST, DERIDDER, LA 70634-4941
(337) 463-2172
(337) 462-3243
Mailing address
603 S PINE ST, DERIDDER, LA 70634-4941
(337) 463-2172
(337) 462-3243
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
05773R
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1320692
—
LA
Enumeration date
07/17/2007
Last updated
07/17/2007
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