| Northshore Gastroenterology, Llc | |
|
4430 Highway 22 Mandeville LA 70471-3310 | |
| (985) 845-9000 | |
| (985) 845-9003 |
| Full Name | Northshore Gastroenterology, Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 4430 Highway 22, Mandeville, Louisiana |
| Authorized Official Name and Position | Hamid Hussain (OWNER) |
| Authorized Official Contact | 9858459000 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Northshore Gastroenterology, Llc 397 Highway 21 Suite 601 Madisonville LA 70447-3407 Ph: (985) 845-9000 | Northshore Gastroenterology, Llc 4430 Highway 22 Mandeville LA 70471-3310 Ph: (985) 845-9000 |
| NPI Number | 1114161890 |
|---|---|
| Provider Enumeration Date | 04/27/2009 |
| Last Update Date | 06/19/2009 |
| Medicare PECOS PAC ID | 0547311391 |
|---|---|
| Medicare Enrollment ID | O20090708000054 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114161890 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | MD13335R (Louisiana) | Primary |
| Provider Name | Hamid Hussain |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1225018989 PECOS PAC ID: 8921050832 Enrollment ID: I20050218000129 |
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