Individual
UZVALTHA GANJI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2495 SHREVEPORT HWY # HWY.71NORTH, MEDICAL CERVISE 111, PINEVILLE, LA 71360-4044
(318) 473-0010
Mailing address
5220 LARK LN, ALEXANDRIA, LA 71303-2435
(318) 442-0970
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
14907R
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1578215
—
LA
Enumeration date
09/04/2006
Last updated
07/08/2007
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