Individual
DAYANAND BAGDURE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1541 KINGS HWY, SHREVEPORT, LA 71103-4228
(318) 626-0000
Mailing address
1512 W KIRBY PL, SHREVEPORT, LA 71103-3822
(318) 626-0287
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
328967
LA
208000000X
Pediatrics Physician
47772
CO
208000000X
Pediatrics Physician
D72899
MD
2080P0203X
Pediatric Critical Care Medicine Physician
Primary
328967
LA
2080P0203X
Pediatric Critical Care Medicine Physician
D72899
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
26880024
—
CO
05
—
335209900
—
MD
Enumeration date
04/14/2008
Last updated
03/22/2024
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