Organization
NORTHLAKE CARDIOLOGY DIAGNOSTICS LLC
Active
Parent organization
NORTHLAKE CARDIOLOGY ASSOCIATES, INC.
Organization subpart
Yes
Provider details
NPI number
Legal business name
NORTHLAKE CARDIOLOGY ASSOCIATES, INC.
Authorized official
DR. MADAELIL G. THOMAS MD (PRESIDENT)
(985) 649-2883
Entity
Organization
Contact information
Practice address
1150 ROBERT BLVD, SUITE 340, SLIDELL, LA 70458-2004
(985) 649-2883
(985) 649-2953
Mailing address
1150 ROBERT BLVD, SUITE 340, SLIDELL, LA 70458-2004
(985) 649-2883
(985) 649-2953
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
05592R
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1316067
—
LA
Enumeration date
12/02/2010
Last updated
12/02/2010
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