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NPI Code Detail

MEDICARE: DR. FERNANDO DAVID NUSSENBAUM M.D

MEDICARE: DR. FERNANDO DAVID NUSSENBAUM M.D
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1390200000XStudent in an Organized Health Care Education/Training ProgramBP10046144TX
2207XS0114XAdult Reconstructive Orthopaedic Surgery PhysicianMD468290GA

General Provider Information

NPI Number : 1205274800
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. FERNANDO DAVID NUSSENBAUM M.D
Provider Business Mailing Address
First Line : 64301 HIGHWAY 434
Second Line :
City : LACOMBE
State : LA
Zip : 70445-5411
Country : US
Telephone Number : 985-882-4500
Fax Number :
Provider Business Practice Location Address
First Line : 3190 E CAUSEWAY APPROACH
Second Line :
City : MANDEVILLE
State : LA
Zip : 70448-3563
Country : US
Telephone Number : 985-882-4500
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/05/2013
Last Update Date : 12/10/2025

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