| Radovi Llc | |
|
7153 Edgewater Dr Mandeville LA 70471-7431 | |
| (504) 914-2908 | |
| (985) 674-4390 |
| Full Name | Radovi Llc |
|---|---|
| Speciality | Psychiatry & Neurology - Psychiatry |
| Location | 7153 Edgewater Dr, Mandeville, Louisiana |
| Authorized Official Name and Position | Shanmuganathan Shantha (DIRECT OWNER) |
| Authorized Official Contact | 5049142908 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Radovi Llc 7153 Edgewater Dr Mandeville LA 70471-7431 Ph: (504) 914-2908 | Radovi Llc 7153 Edgewater Dr Mandeville LA 70471-7431 Ph: (504) 914-2908 |
| NPI Number | 1619228509 |
|---|---|
| Provider Enumeration Date | 10/02/2012 |
| Last Update Date | 10/02/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619228509 | NPI | - | NPPES |
| 1422029 | Medicaid | LA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | 15098R (Louisiana) | Primary |
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