Organization
WESTBANK RENAL ASSOCIATES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHAKKUNGAL P. DEVIDOSS M.D (OWNER)
(504) 349-6808
Entity
Organization
Contact information
Practice address
1111 MEDICAL CENTER BLVD, SUITE N 304, MARRERO, LA 70072-3151
(504) 349-6808
(504) 349-6811
Mailing address
1111 MEDICAL CENTER BLVD, SUITE N 304, MARRERO, LA 70072-3151
(504) 349-6808
(504) 349-6811
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
03747R
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1347787
—
LA
Enumeration date
09/27/2007
Last updated
01/27/2009
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