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Individual
JUAN MEDAURA
Active
Individual
JUAN MEDAURA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
24487
MS
207RN0300X
Nephrology Physician
Primary
330645
LA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
07624070
—
MS
05
—
2582445
—
LA
01
—
P01788687
RAILROAD MEDICARE
MS
Enumeration date
04/12/2011
Last updated
06/01/2022
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