Basic Information
| Provider Information | |||||||||
| NPI: | 1740227685 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | VISWANATHAN | ||||||||
| FirstName: | SUSHEELA | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6 LAKEWOOD ESTATES DR | ||||||||
| Address2: | |||||||||
| City: | NEW ORLEANS | ||||||||
| State: | LA | ||||||||
| PostalCode: | 701318358 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5043949355 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2021 PERDIDO ST | ||||||||
| Address2: | |||||||||
| City: | NEW ORLEANS | ||||||||
| State: | LA | ||||||||
| PostalCode: | 701121352 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5045682315 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/31/2006 | ||||||||
| LastUpdateDate: | 12/04/2008 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | 05730R | LA | Y | Allopathic & Osteopathic Physicians | Anesthesiology |
ID Information
| ID | Type | State | Issuer | Description | 1342441 | 05 | LA | MEDICAID | 00124129 | 05 | MS | MEDICAID |