Individual
RIDDHI S BANTHIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
7777 HENNESSY BLVD STE 701, BATON ROUGE, LA 70808-4370
(225) 765-5864
(225) 765-2013
Mailing address
1250 E. MARSHALL ST., BOX 980509, RICHMOND, VA 23298
(804) 828-8786
(804) 828-5466
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
320100
LA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
055594
STATE NARCOTICS LICENSE
LA
01
—
320100
STATE LICENSE
LA
Enumeration date
04/29/2016
Last updated
03/07/2023
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