Individual
DR. MAHESH R PANDYA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
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
L05773R
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1320692
—
LA
01
—
1366641540
NPI
LA
01
—
POO110446
RAILROAD MEDICARE
LA
Enumeration date
08/11/2005
Last updated
05/19/2011
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