Individual
ANDREW PAUL KOMONAKA FUGLESTAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3316 STATE STREET DR, NEW ORLEANS, LA 70125-4245
(218) 341-4311
Mailing address
3316 STATE STREET DR, NEW ORLEANS, LA 70125-4245
(218) 341-4311
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
04/02/2022
Last updated
04/02/2022
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