Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Y00000X | Otolaryngologist (ENT Doctor) | 01012412422 | VA |
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | MD2016-0851 | NM |
N | 207YP0228X | Pediatric Otolaryngology | 0101241422 | VA |
NPI | 1821140765 |
---|---|
Provider Name | Dr. Belinda A Mantle |
First Address | New Orleans, LA 70118 |
Second Address | New Orleans, LA 70118 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/01/2007 |
Last Update Date | 16/01/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0014 | CAREFIRST (01) | |
01012412422 | STATE LICENSE (01) | VA |
MD2016-0851 | MEDICAL LICENSE (01) | NM |