Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QA0505X | Family Doctor - Adult Medicine | 012112 | LA |
NPI | 1114055548 |
---|---|
Provider Name | Dr. Mary Madonna Baudier |
First Address | New Orleans, LA 70115-3500 |
Second Address | New Orleans, LA 70115-3500 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/02/2007 |
Last Update Date | 09/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1332658 | (05) | LA |
D79747 | (02) | LA |