Individual
DR. GHIATH M MIKDADI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
16033 DOCTORS BLVD, HAMMOND, LA 70403-1479
(985) 974-9278
(985) 542-6341
Mailing address
16033 DOCTORS BLVD, HAMMOND, LA 70403-1479
(985) 974-9278
(985) 542-6341
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
11934R
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04506271
—
MS
05
—
1687448
—
LA
Enumeration date
06/01/2005
Last updated
05/26/2011
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