Provider Demographics
NPI:1174835631
Name:NAIDU, DURGA P (MD, FAAP, FACC)
Entity type:Individual
Prefix:DR
First Name:DURGA
Middle Name:P
Last Name:NAIDU
Suffix:
Gender:M
Credentials:MD, FAAP, FACC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1003 CAMELLIA BLVD STE 101
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70508-7248
Mailing Address - Country:US
Mailing Address - Phone:337-456-6892
Mailing Address - Fax:337-735-3038
Practice Address - Street 1:1003 CAMELLIA BLVD STE 101
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70508-7248
Practice Address - Country:US
Practice Address - Phone:337-456-6892
Practice Address - Fax:337-735-3038
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-12
Last Update Date:2024-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA3046832080P0202X, 2080P0202X
TXBP200480902080P0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2080P0202XAllopathic & Osteopathic PhysiciansPediatricsPediatric CardiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA2452622Medicaid
TXBP20048090Medicaid