MEDICARE: DR. MICHAEL DAVID DILEO 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
1	207YX0602X	Otolaryngic Allergy Physician	021089	LA
2	207Y00000X	Otolaryngology Physician	021089	LA

Other Identifiers

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

General Provider Information

NPI Number	:	1578563474
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHAEL DAVID DILEO M.D.

Provider Business Mailing Address
First Line	:	5959 S SHERWOOD FOREST BLVD
Second Line	:
City	:	BATON ROUGE
State	:	LA
Zip	:	70816-6038
Country	:	US
Telephone Number	:	225-526-0002
Fax Number	:	225-765-9196

Provider Business Practice Location Address
First Line	:	4950 ESSEN LN STE 400
Second Line	:
City	:	BATON ROUGE
State	:	LA
Zip	:	70809-3738
Country	:	US
Telephone Number	:	225-765-1765
Fax Number	:	225-765-1768

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

Provider Enumeration Date	:	07/21/2005
Last Update Date	:	08/31/2021

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Directions to “ DR. MICHAEL DAVID DILEO M.D.” Practice Location

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