Wagih R Mando, M.D

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

09630R Issued in LA

Practice address

200 W Esplanade Ave
Suite 410
Kenner, LA 70065-2489

Phone

(504) 464-8619

Fax

(504) 464-4876

NPI assigned

Apr 3, 2006

Last updated

Apr 13, 2011By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Wagih Mando, M.D., Facs., LLC

  • Surgery Physician
  • Kenner, LA
  • NPI 1093993172
  Authorized official Same address or phone
• Wagih R Mando, MD Facs LLC

  • Surgery Physician
  • Kenner, LA
  • NPI 1861676702
  Authorized official Same address or phone
• CRH Clinic of Louisiana, Inc

  • Surgery Physician
  • Kenner, LA
  • NPI 1780851832
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1144022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1302652800000",
    "number": "1255393526",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 W ESPLANADE AVE",
            "address_2": "SUITE 410",
            "city": "KENNER",
            "state": "LA",
            "postal_code": "700652489",
            "telephone_number": "504-464-8619",
            "fax_number": "504-464-4876"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 W ESPLANADE AVE",
            "address_2": "SUITE 410",
            "city": "KENNER",
            "state": "LA",
            "postal_code": "700652489",
            "telephone_number": "504-464-8619",
            "fax_number": "504-464-4876"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANDO",
        "first_name": "WAGIH",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-03",
        "last_updated": "2011-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "LA",
            "license": "09630R",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1966312",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Vinicio Eduardo Madrigal Sr., MD
• Lauren Maenza, DDS
• Brandon Christopher Mahl, D.C.
• Hung Mai, AU.D.
• Quynh Minh Mai, MD
• Zoie Marie Manuel, MS, CCC-SLP
• Marillac Community Health Centers (Daughters of Charity Health Center-Kenner)
• Marillac Community Health Centers (DePaul Community Health Centers-Our Lady of Perpetual Help)
• Marillac Community Health Centers (Daughters of Charity Health Centers)
• Melody Marks, LPCS

• Surgery Physician in Kenner, LA
• Providers in Kenner, LA by specialty
• Surgery Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.