Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207XS0106X | Orthopaedic Hand Surgeon | 54625 | CO |
Y | 207XS0106X | Orthopaedic Hand Surgeon | 54625 | LA |
NPI | 1174782213 |
---|---|
Provider Name | Nader A Shourbaji |
First Address | Hammond, LA 70404-2668 |
Second Address | Hammond, LA 70403-1431 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/06/2008 |
Last Update Date | 15/06/2021 |