Individual
SRINIVAS S GANJI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
209 HIGHLAND PARK PLZ, COVINGTON, LA 70433-7130
(985) 892-6291
(985) 892-8077
Mailing address
209 HIGHLAND PARK PLZ, COVINGTON, LA 70433-7130
(985) 892-6291
(985) 892-8077
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
05634R
LA
2084N0600X
Clinical Neurophysiology Physician
05634R
LA
2084S0012X
Sleep Medicine (Psychiatry & Neurology) Physician
05634R
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1324353
—
LA
Enumeration date
07/18/2006
Last updated
06/20/2012
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