Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0117X | Orthopaedic Spine Surgeon | 204973 | LA |
NPI | 1386692325 |
---|---|
Provider Name | Paul Peter Dimartino |
First Address | New Orleans, LA 70112-2865 |
Second Address | New Orleans, LA 70112-2865 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/05/2006 |
Last Update Date | 15/05/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
006405631 | (05) | VA |
0491953 | CIGNA (01) | VA |
08936187200 | OHIO WORK COMP (01) | VA |
0900797 | UNITED HEALTHCARE (01) | VA |
1005877 | US HEALTHCARE-AETNA HMO (01) | VA |
107537 | ANTHEM BC/BS (01) | VA |
13765 | SENTARA-OPTIMA HEALTH (01) | VA |
150146600 | US DEPT OF LABOR (01) | VA |
19706 | CARENET-MEDICAID (01) | VA |
258231 | MDIPA,MAMSI,OPTIMUM CHOIC (01) | VA |
4023216 | AETNA (01) | VA |
54-1739189 | FED TAX ID (01) | VA |
83299 | SOUTHERN HEALTH (01) | VA |
A92331 | (02) | VA |