Organization
CHILDRENS CLINIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MUHAMMAD SHUJA MD (PART OWNER)
(985) 764-6556
Entity
Organization
Contact information
Practice address
3 STOREHOUSE LANE, SUITE B, DESTREHAN, LA 70047
(985) 764-6556
(985) 764-6526
Mailing address
3 STOREHOUSE LANE, SUITE B, DESTREHAN, LA 70047
(985) 764-6556
(985) 764-6526
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1445924
—
LA
Enumeration date
12/27/2006
Last updated
08/22/2020
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