Individual
MAROUN MHANNA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1541 KINGS HWY, SHREVEPORT, LA 71103-4228
(318) 626-0000
Mailing address
1512 W KIRBY PL, SHREVEPORT, LA 71103-3822
(318) 626-0177
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
322403
LA
2080N0001X
Neonatal-Perinatal Medicine Physician
322403
LA
2080P0203X
Pediatric Critical Care Medicine Physician
Primary
322403
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2121975
—
OH
Enumeration date
07/04/2006
Last updated
12/14/2022
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