Individual
NOOR ALI WALLIMOHAMMED JIWANI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2000 OPELOUSAS STREET, LAKE CHARLES, LA 70601
(337) 439-9983
(337) 439-3224
Mailing address
2000 OPELOUSAS STREET, LAKE CHARLES, LA 70601
(337) 439-9983
(337) 439-3224
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
MD204690
LA
207Q00000X
Family Medicine Physician
ME107815
FL
207V00000X
Obstetrics & Gynecology Physician
Primary
MD.202288
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1082066
—
LA
Enumeration date
06/11/2008
Last updated
08/26/2013
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