Individual provider · NPI-1

Sidra Shakeel Ahsan, MD

Internal Medicine, Gastroenterology · Shreveport, LA

NPI number1477073906
StatusActive
Last updated in NPPESSep 5, 2024

Details

NPI
1477073906
Entity type
Individual (NPI-1)
Name
Sidra Shakeel Ahsan
Credential
MD
Sex
Female
Sole proprietor
Yes
Enumeration date
Jun 26, 2017
Certification date
Sep 5, 2024
Last updated
Sep 5, 2024

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207RG0100X Internal Medicine, Gastroenterology343003LAYes
207R00000X Internal Medicine343003LA
207R00000X Internal Medicine125.069852IL

Practice location

1541 Kings Hwy
Shreveport, LA 71103-4228

Phone 318-626-0000

Mailing address

1541 Kings Hwy
Attn: Payor Credentialing
Shreveport, LA 71103-4228

Phone 318-626-0287

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