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NPI Code Detail

MEDICARE: RENATA PILATOVA M.D.

MEDICARE: RENATA PILATOVA 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
1208000000XPediatrics Physician11367RLA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1356331458
Entity Type Code : Individual
Provider Name (Legal Business Name) : RENATA PILATOVA M.D.
Provider Business Mailing Address
First Line : 710 VERSAILLES BLVD
Second Line :
City : ALEXANDRIA
State : LA
Zip : 71303-2351
Country : US
Telephone Number : 318-449-4474
Fax Number :
Provider Business Practice Location Address
First Line : 710 VERSAILLES BLVD
Second Line :
City : ALEXANDRIA
State : LA
Zip : 71303-2351
Country : US
Telephone Number : 318-449-4474
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/28/2005
Last Update Date : 02/23/2022

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Directions to “ RENATA PILATOVA M.D.” Practice Location

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