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Individual

DR. MARWAN KASKAS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2501 GREENWOOD RD, SHREVEPORT, LA 71103-3905
(318) 631-1584
(318) 635-8322
Mailing address
1800 BUCKNER ST, SUITE C120, SHREVEPORT, LA 71101-4440
(318) 227-8899
(318) 222-0407

Taxonomy

Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
09084R
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
106981702
TEXAS MEDICAID
TX
05
1932469
LA
01
3100063
UNITED HEALTHCARE
01
390005504
RAILROAD MEDICARE
LA
01
721404303KA1
OCHSNER
01
A004
CHAMPUS
LA
Enumeration date
09/20/2005
Last updated
07/01/2010
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