Individual
PAUL PETER DIMARTINO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1542 TULANE AVE, BOX T6-7, NEW ORLEANS, LA 70112-2865
(504) 568-4680
(504) 568-4466
Mailing address
1542 TULANE AVE, BOX T6-7, NEW ORLEANS, LA 70112-2865
(504) 568-4680
(504) 568-4466
Taxonomy
Speciality
Code
Description
License number
State
207XS0117X
Orthopaedic Surgery of the Spine Physician
Primary
204973
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
006405631
—
VA
01
—
0491953
CIGNA
VA
01
—
08936187200
OHIO WORK COMP
VA
01
—
0900797
UNITED HEALTHCARE
VA
01
—
1005877
US HEALTHCARE-AETNA HMO
VA
01
—
107537
ANTHEM BC/BS
VA
01
—
13765
SENTARA-OPTIMA HEALTH
VA
01
—
150146600
US DEPT OF LABOR
VA
01
—
19706
CARENET-MEDICAID
VA
01
—
258231
MDIPA,MAMSI,OPTIMUM CHOIC
VA
01
—
4023216
AETNA
VA
01
—
54-1739189
FED TAX ID
VA
01
—
83299
SOUTHERN HEALTH
VA
Enumeration date
05/04/2006
Last updated
05/15/2014
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