Individual
SAM MOGHTADER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1514 JEFFERSON HWY, NEW ORLEANS, LA 70121-2429
(504) 842-4000
Mailing address
2750 GAUSE BLVD E, SLIDELL, LA 70461-4149
(985) 639-3777
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
A117716
CA
207Q00000X
Family Medicine Physician
Primary
MD.205439
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
05228581
—
MS
05
—
2306171
—
LA
Enumeration date
05/27/2010
Last updated
12/01/2021
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