Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RN0300X | Nephrologist | 301705 | LA |
NPI | 1033497698 |
---|---|
Provider Name | Dr. Ramzi Barnaba Vareldzis |
First Address | New Orleans, LA 70112-2865 |
Second Address | Jackson, MS 39204 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/08/2011 |
Last Update Date | 15/05/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
21668 | LICENSE (01) | MS |