Individual
AMOL MADAN TAKALKAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1505 KINGS HWY, PET IMAGING CENTER, BRF, SHREVEPORT, LA 71103-4228
(318) 675-4050
Mailing address
9303 SHENANDOAH CIR, SHREVEPORT, LA 71115-3743
(318) 795-0775
Taxonomy
Speciality
Code
Description
License number
State
207U00000X
Nuclear Medicine Physician
85681
GA
207U00000X
Nuclear Medicine Physician
Primary
MD.200309
LA
207UN0901X
Nuclear Cardiology Physician
MD.200309
LA
207UN0902X
Nuclear Imaging & Therapy Physician
MD.200309
LA
207UN0903X
In Vivo & In Vitro Nuclear Medicine Physician
MD.200309
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1626554
—
LA
Enumeration date
04/13/2006
Last updated
05/26/2020
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