| Doctor Name: | DR. MAHMOUD DAFTARY |
| NPI Number: | 1063411361 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MD |
| License Number: | 04535R |
| Business Practice Address: | 2750 Gause Blvd. East Slidell, LA - 70461 |
| Business Phone Number: | 9856393777 |
| Business Fax Number: | |
| Mailing Address: | 1514 Jefferson Highway, NEW ORLEANS |
| State: | LA |
| Postal Code: | 70121 |
| Phone Number: | 5048424000 |
| Fax Number: | |
| NPI Enumeration Date: | 07/19/2005 |
| NPI Last Update Date: | 11/19/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 174400000X |
| License Number: | 04535R |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | LA |
| Taxonomy Type: | Other Service Providers |
| Taxonomy Classification: | Specialist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |