Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XP3100X | Pediatric Orthopaedic Surgeon | GETP | LA |
NPI | 1306193917 |
---|---|
Provider Name | Dr. Sushant D Ghate |
First Address | New Orleans, LA 70115-7063 |
Second Address | New Orleans, LA 70118-5720 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/08/2012 |
Last Update Date | 22/08/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2304569 | (05) | LA |