Individual
DR. CHARLES RAYMOND GENOVESE JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
312 EAST RAILROAD AVENUE, INDEPENDENCE, LA 70443
(985) 878-4183
(985) 878-3830
Mailing address
3926 BARRON ST STE C210, METAIRIE, LA 70002-5798
(504) 887-3142
(504) 837-3145
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
015669
LA
207R00000X
Internal Medicine Physician
Primary
MD.015669
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1335681
—
LA
Enumeration date
07/26/2006
Last updated
12/27/2024
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