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Individual

ANDREW WILLIAM GOTTSCHALK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1201 S CLEARVIEW PKWY, STE 104, JEFFERSON, LA 70121-1015
(504) 736-4800
Mailing address
1514 JEFFERSON HWY, NEW ORLEANS, LA 70121-2429
(504) 842-4000

Taxonomy

Speciality
Code
Description
License number
State
207QS0010X
Sports Medicine (Family Medicine) Physician
259369
NY
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
MD208145
LA
207QS0010X
Sports Medicine (Family Medicine) Physician
MD441388
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00709541
MS
05
03296595
NY
05
102534788
PA
05
2402706
LA
05
778143000
MN
Enumeration date
04/02/2007
Last updated
12/30/2015
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