Individual
DR. MICHAEL DAVID MODICA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2021 PERDIDO ST FL 5, NEW ORLEANS, LA 70112-1352
(504) 568-5600
(504) 568-7884
Mailing address
2021 PERDIDO ST FL 5, NEW ORLEANS, LA 70112-1352
(504) 568-5600
(504) 568-7884
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
208088
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2361490
—
LA
Enumeration date
03/26/2014
Last updated
07/03/2023
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