| East Jefferson Gastroenterology Inc | |
|
3941 Houma Blvd Ste 1b Metairie LA 70006-2920 | |
| (504) 888-0388 | |
| (504) 888-9119 |
| Full Name | East Jefferson Gastroenterology Inc |
|---|---|
| Speciality | Internal Medicine |
| Location | 3941 Houma Blvd, Metairie, Louisiana |
| Authorized Official Name and Position | David A Dulitz (OWNER) |
| Authorized Official Contact | 5048880388 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| East Jefferson Gastroenterology Inc 3941 Houma Blvd Ste 1b Metairie LA 70006-2920 Ph: (504) 888-0388 | East Jefferson Gastroenterology Inc 3941 Houma Blvd Ste 1b Metairie LA 70006-2920 Ph: (504) 888-0388 |
| NPI Number | 1336360007 |
|---|---|
| Provider Enumeration Date | 05/01/2007 |
| Last Update Date | 08/15/2008 |
| Medicare PECOS PAC ID | 1052389244 |
|---|---|
| Medicare Enrollment ID | O20040924000582 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336360007 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | 11984R (Louisiana) | Primary |
| Provider Name | David A Dulitz |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1073547592 PECOS PAC ID: 3072586114 Enrollment ID: I20040817000273 |
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