Individual
MARIA IMELDA BAUTISTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1303 HENRY CLAY AVENUE, NEONATAL MEDICAL GROUP, NEW ORLEANS, LA 70118
(504) 896-2229
(504) 896-8835
Mailing address
1303 HENRY CLAY AVENUE, NEONATAL MEDICAL GROUP, NEW ORLEANS, LA 70118
(504) 896-2229
(504) 896-8835
Taxonomy
Speciality
Code
Description
License number
State
2080N0001X
Neonatal-Perinatal Medicine Physician
Primary
07109R
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1361852
—
LA
Enumeration date
12/18/2006
Last updated
07/08/2007
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