Shalini Grant, MD | |
4630 Ambassador Caffery Pkwy Ste 102, Lafayette, LA 70508-6949 | |
(337) 989-2322 | |
(337) 981-0183 |
Full Name | Shalini Grant |
---|---|
Gender | Female |
Speciality | Pediatrics |
Location | 4630 Ambassador Caffery Pkwy Ste 102, Lafayette, Louisiana |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1871702225 | NPI | - | NPPES |
511-08012 | Other | AL | BCBS |
511-08013 | Other | AL | BCBS |
120790 | Medicaid | AL | |
120787 | Medicaid | AL | |
121204 | Medicaid | AL | |
121205 | Medicaid | AL | |
511-08011 | Other | AL | BCBS |
511-06829 | Other | AL | BLUE CROSS BLUE SHIELD LOCATION ID |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208000000X | Pediatrics | 27990 (Alabama) | Secondary |
208000000X | Pediatrics | 204769 (Louisiana) | Primary |
Entity Name | Lourdes Physician Group Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1437405883 PECOS PAC ID: 7214177757 Enrollment ID: O20130705000541 |
Mailing Address | Practice Location Address |
---|---|
Shalini Grant, MD 5959 S Sherwood Forest Blvd, Baton Rouge, LA 70816-6038 Ph: (337) 989-2322 | Shalini Grant, MD 4630 Ambassador Caffery Pkwy Ste 102, Lafayette, LA 70508-6949 Ph: (337) 989-2322 |
Dr. Sheung Man Alexander Sin, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 2390 W Congress St, Lafayette, LA 70506 Phone: 615-322-5000 | |
Karl M. Valcourt, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 4600 Ambassador Caffery Pkwy, Lafayette, LA 70508 Phone: 337-470-2605 | |
Neva Ducote Seago, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 4600 Ambassador Caffery Pkwy, Women's And Children's Hospital, Lafayette, LA 70508 Phone: 337-521-9100 | |
Dr. Colleen C Sicard, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 200 Beaullieu Dr Ste 7, Lafayette, LA 70508 Phone: 337-366-8616 Fax: 337-366-8133 | |
Dr. Virginia B Coreil, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 5000 Ambassador Caffery Pkwy Bldg 12, Lafayette, LA 70508 Phone: 337-470-3150 Fax: 337-470-3161 | |
Dr. Ebenezer S. Bediako, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 4600 Ambassador Caffery Pkwy, Lafayette, LA 70508 Phone: 337-470-5500 Fax: 337-521-9166 | |
Mr. Cong T Vo, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 107 Montrose Avenue, Suite D, Lafayette, LA 70503 Phone: 337-981-9316 Fax: 337-981-8303 |