Provider Demographics
NPI:1942786538
Name:SSDN SAHARANS, INC
Entity type:Organization
Organization Name:SSDN SAHARANS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RAMAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SAHARAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:603-494-3189
Mailing Address - Street 1:3029 DEBORAH DR
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:LA
Mailing Address - Zip Code:71201-1955
Mailing Address - Country:US
Mailing Address - Phone:603-494-3189
Mailing Address - Fax:
Practice Address - Street 1:1401 EZELLE ST
Practice Address - Street 2:
Practice Address - City:RUSTON
Practice Address - State:LA
Practice Address - Zip Code:71270-7218
Practice Address - Country:US
Practice Address - Phone:318-251-3126
Practice Address - Fax:318-251-6257
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-17
Last Update Date:2020-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty