| |
2820 Napoleon Ave Suite 890 New Orleans LA 70115-6969 | |
(504) 412-1366 | |
Not Available |
Full Name | |
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Speciality | Internal Medicine |
Location | 2820 Napoleon Ave, New Orleans, Louisiana |
Authorized Official Name and Position | Ellis Johann Bultman (DIRECTOR) |
Authorized Official Contact | 5043884396 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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1525 Louisiana Ave New Orleans LA 70115-3507 Ph: (504) 895-4396 | 2820 Napoleon Ave Suite 890 New Orleans LA 70115-6969 Ph: (504) 412-1366 |
NPI Number | 1144539214 |
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Provider Enumeration Date | 10/06/2010 |
Last Update Date | 10/06/2010 |
Identifier | Type | State | Issuer |
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1144539214 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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207R00000X | Internal Medicine | (* (Not Available)) | Primary |
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