Daftary, Mahmoud

Daftary, Mahmoud is an individual health care provider with primary practice located at 2750 Gause Blvd. East , Slidell LA 70461. He recently has 2 registered licenses in different health care specialties including Other Service Providers / Specialist, Allopathic & Osteopathic Physicians / Urology. Allopathic & Osteopathic Physicians / Urology is his primary health care specialty. Daftary, Mahmoud can be contacted via phone (985) 639-3777.

Contact Information

Primary practice address
2750 Gause Blvd. East Slidell LA 70461
Phone: (985) 639-3777
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X 04535R Louisiana
Allopathic & Osteopathic Physicians / Urology 208800000X MD.04535R Louisiana

Profile Details

NPI number 1063411361
LBN Legal business name Daftary, Mahmoud
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 19th, 2005
Last updated Nov 19th, 2009 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1063411361 NPPES
Mississippi MEDICAID 00122909
Mississippi MEDICAID 1329444
Mississippi Other P00396221

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