MEDICARE: MARIE YOLENE FERVIL MD

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
1	171W00000X	Contractor	28282	SC
2	208M00000X	Hospitalist Physician	055219	GA
3	207R00000X	Internal Medicine Physician	MD.206661	LA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	P00992327	OTHER		RR MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	52038519002	OTHER	GA	BCBS-TMC
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	581719867 002	OTHER	GA	BCBS-AMB
7	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
8	52038519 003	OTHER	GA	BCBS-DH
9	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1518076439
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARIE YOLENE FERVIL MD

Provider Business Mailing Address
First Line	:	1101 MEDICAL CENTER BLVD.
Second Line	:	HOSPITALIST DEPARTMENT
City	:	MARRERO
State	:	LA
Zip	:	70072
Country	:	US
Telephone Number	:	504-349-1656
Fax Number	:	504-349-1933

Provider Business Practice Location Address
First Line	:	1101 MEDICAL CENTER BLVD.
Second Line	:	HOSPITALIST DEPARTMENT
City	:	MARRERO
State	:	LA
Zip	:	70072
Country	:	US
Telephone Number	:	504-349-1656
Fax Number	:	504-349-1933

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/30/2006
Last Update Date	:	08/13/2015

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Directions to “ MARIE YOLENE FERVIL MD” Practice Location

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