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Individual

OLIVER MOLLERE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
4225 LAPALCO BLVD, MARRERO, LA 70072-4338
(504) 371-9355
Mailing address
1514 JEFFERSON HWY, NEW ORLEANS, LA 70121-2429
(504) 842-4000

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD.205723
LA
390200000X
Student in an Organized Health Care Education/Training Program

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
06771046
LA
05
2107178
LA
Enumeration date
04/08/2010
Last updated
04/23/2015
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