Individual
DR. NITIN WALYAT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1501 KINGS HWY, SHREVEPORT, LA 71103
(318) 675-4881
(318) 675-5069
Mailing address
1501 KINGS HWY, ATTN: LEISA OGLESBY (RM. 1-201), SHREVEPORT, LA 71103-4228
(318) 675-4881
(318) 675-5069
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
MD.205325
LA
208000000X
Pediatrics Physician
R2499
TX
2080N0001X
Neonatal-Perinatal Medicine Physician
Primary
MD.205325
LA
2080N0001X
Neonatal-Perinatal Medicine Physician
R2499
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2194704
—
LA
01
—
4R030F600
MEDICARE PTAN
LA
Enumeration date
04/20/2009
Last updated
03/15/2023
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