1942205778 NPI number — JAIME MICHEL MD

Table of content: JAIME MICHEL MD (NPI 1942205778)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1942205778 NPI number — JAIME MICHEL MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MICHEL
Provider First Name:
JAIME
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1942205778
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/11/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
298 HENRY CLAY AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NEW ORLEANS
Provider Business Mailing Address State Name:
LA
Provider Business Mailing Address Postal Code:
70118-5720
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
504-896-9827
Provider Business Mailing Address Fax Number:
504-894-5370

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3100 KINGMAN ST
Provider Second Line Business Practice Location Address:
STE 110
Provider Business Practice Location Address City Name:
METAIRIE
Provider Business Practice Location Address State Name:
LA
Provider Business Practice Location Address Postal Code:
70006-5419
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
504-887-6355
Provider Business Practice Location Address Fax Number:
504-888-3747
Provider Enumeration Date:
06/17/2005

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 208000000X , with the licence number:  026098 , registered in the state of LA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)