Individual
RAJA M. MOUALLEM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
200 HENRY CLAY AVE, NEW ORLEANS, LA 70118-5720
(504) 412-1835
Mailing address
200 HENRY CLAY AVE, NEW ORLEANS, LA 70118-5720
(504) 412-1835
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
011807
LA
2080P0204X
Pediatric Emergency Medicine (Pediatrics) Physician
Primary
011807
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
09672573
—
MS
05
—
1330990
—
LA
Enumeration date
07/22/2006
Last updated
12/15/2010
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