Individual
DR. NANCY ELIZABETH DIETHELM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1514 JEFFERSON HWY, NEW ORLEANS, LA 70121-2429
(504) 842-4000
Mailing address
1514 JEFFERSON HWY, NEW ORLEANS, LA 70121-2429
(504) 842-4000
Taxonomy
Speciality
Code
Description
License number
State
2085B0100X
Body Imaging Physician
Primary
MD.10144R
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04302561
—
MS
05
—
1974731
—
LA
Enumeration date
07/21/2006
Last updated
11/20/2007
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