Individual
JUAN MEDAURA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3525 PRYTANIA ST STE 402, NEW ORLEANS, LA 70115-3585
(504) 648-2520
(504) 897-2939
Mailing address
3600 PRYTANIA ST STE 35, NEW ORLEANS, LA 70115-3678
(504) 897-8412
(504) 249-5311
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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