Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2080P0207X | Pediatric Hematology-Oncologist | AJ4147357 | MD |
Y | 2080P0207X | Pediatric Hematology-Oncologist | MD.203232 | LA |
NPI | 1194862300 |
---|---|
Provider Name | Dr. Craig David Lotterman |
First Address | New Orleans, LA 70121 |
Second Address | New Orleans, LA 70121 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/01/2007 |
Last Update Date | 19/11/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
04601070 | (05) | MS |
1893471 | (05) | LA |