Provider Demographics
NPI:1366475493
Name:ELKERSH, MOHAMED (MD)
Entity type:Individual
Prefix:
First Name:MOHAMED
Middle Name:
Last Name:ELKERSH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:42131 VETERANS AVE
Mailing Address - Street 2:STE. 100
Mailing Address - City:HAMMOND
Mailing Address - State:LA
Mailing Address - Zip Code:70403-1428
Mailing Address - Country:US
Mailing Address - Phone:985-345-7246
Mailing Address - Fax:985-345-7249
Practice Address - Street 1:42131 VETERANS AVE
Practice Address - Street 2:STE. 100
Practice Address - City:HAMMOND
Practice Address - State:LA
Practice Address - Zip Code:70403-1428
Practice Address - Country:US
Practice Address - Phone:985-345-7246
Practice Address - Fax:985-345-7249
Is Sole Proprietor?:No
Enumeration Date:2006-07-09
Last Update Date:2011-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAMD.15437R207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1031755Medicaid
LA1031755Medicaid