Individual
MELANIE MOORE WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1514 JEFFERSON HWY, NEW ORLEANS, LA 70121-2429
(504) 842-3915
(504) 842-2036
Mailing address
2500 BELLE CHASSE HWY, TERRYTOWN, LA 70056-7127
(504) 842-4000
Taxonomy
Speciality
Code
Description
License number
State
207LC0200X
Critical Care Medicine (Anesthesiology) Physician
Primary
MD.207226
LA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2372262
—
LA
Enumeration date
04/16/2008
Last updated
10/24/2014
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