Individual
EDMUND NAGEM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5000 AMBASSADOR CAFFERY PKWY, BLDG 14A, LAFAYETTE, LA 70508-6984
(337) 470-3580
(337) 470-3586
Mailing address
5000 AMBASSADOR CAFFERY PKWY, BLDG 14A, LAFAYETTE, LA 70508-6984
(337) 470-2296
(337) 470-2019
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1197505
—
LA
01
—
780002059
RR MEDICARE
LA
Enumeration date
07/20/2006
Last updated
02/26/2016
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