Provider Demographics
NPI:1447249800
Name:AHLUWALIA, JATINDER P (MD)
Entity type:Individual
Prefix:
First Name:JATINDER
Middle Name:P
Last Name:AHLUWALIA
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4400A AMBASSADOR CAFFERY PKWY
Mailing Address - Street 2:#287
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70508
Mailing Address - Country:US
Mailing Address - Phone:337-205-7474
Mailing Address - Fax:337-205-7475
Practice Address - Street 1:1101 S COLLEGE RD
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70503-3038
Practice Address - Country:US
Practice Address - Phone:337-656-3322
Practice Address - Fax:337-205-7475
Is Sole Proprietor?:No
Enumeration Date:2005-10-18
Last Update Date:2025-03-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WI73849207RG0100X
IL036114397207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036114397Medicaid
ILK21068Medicare PIN
IL036114397Medicaid