Individual
JAIME E BUSTAMANTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1514 JEFFERSON HWY, NEW ORLEANS, LA 70121-2429
(504) 842-2256
Mailing address
1514 JEFFERSON HWY, NEW ORLEANS, LA 70121-2429
(504) 842-4000
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD.10798R
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1683655
—
LA
Enumeration date
07/01/2006
Last updated
08/07/2014
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