Basic Information
| Provider Information | |||||||||
| NPI: | 1578904199 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | AHUJA | ||||||||
| FirstName: | SHRADHA | ||||||||
| MiddleName: | |||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3600 PRYTANIA ST STE 35 | ||||||||
| Address2: | |||||||||
| City: | NEW ORLEANS | ||||||||
| State: | LA | ||||||||
| PostalCode: | 701153678 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5048978412 | ||||||||
| FaxNumber: | 5042495311 | ||||||||
| Practice Location | |||||||||
| Address1: | 1401 FOUCHER ST | ||||||||
| Address2: | |||||||||
| City: | NEW ORLEANS | ||||||||
| State: | LA | ||||||||
| PostalCode: | 701153515 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5048978970 | ||||||||
| FaxNumber: | 5048978777 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/11/2013 | ||||||||
| LastUpdateDate: | 06/01/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 06/01/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208M00000X | 24481 | MS | N | Allopathic & Osteopathic Physicians | Hospitalist | 207RH0003X | 331087 | LA | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Hematology & Oncology |
ID Information
| ID | Type | State | Issuer | Description | 192170 | 05 | AL | MEDICAID | 06120550 | 05 | MS | MEDICAID |