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TAMARA AISHA MARRYSHOW GRANADOS MD NPI 1982124244


NPI Information

NPI: 1982124244
Provider Name: TAMARA AISHA MARRYSHOW GRANADOS, MD
Classification: Family Medicine - 207Q00000X
Entity Type: Individual
Organization: OUR LADY OF THE LAKE PHYSICIAN GROUP LLC

PECOS Registration: Yes

Address:
12525 PERKINS RD STE A
BATON ROUGE, LA
ZIP 70810
Phone: (225) 761-4256
Get Directions

Tamara Aisha Marryshow Granados, MD is a family medicine in Baton Rouge, LA with 7 years of experience. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. Tamara Aisha Marryshow Granados, MD NPI is 1982124244. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

12525 PERKINS RD STE A
BATON ROUGE, LA
ZIP 70810-907
Phone: (225) 761-4256
Fax: (225) 761-4034

The NPI 1982124244 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 6/27/2017 and was last updated on 1/22/2021.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207Q00000XFamily Medicine322666LOUISIANAYes
2207Q00000XFamily MedicineLP04112RHODE ISLANDNo

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1LP04112OTHERRHODE ISLANDRHODE ISLAND MEDICAL LICENSE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.