Individual
TAMIKA A WEBB DETEGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1514 JEFFERSON HWY, NEW ORLEANS, LA 70121
(504) 842-4000
Mailing address
1514 JEFFERSON HWY, NEW ORLEANS, LA 70121
(504) 842-4000
Taxonomy
Speciality
Code
Description
License number
State
207RR0500X
Rheumatology Physician
Primary
MD201655
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
09805391
—
MS
05
—
1015580
—
LA
05
—
63140427
—
AL
Enumeration date
08/30/2007
Last updated
01/09/2008
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