MEDICARE: ANDREA D. GERMOND 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	207R00000X	Internal Medicine Physician	MD.204985	LA

General Provider Information

NPI Number	:	1659696912
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANDREA D. GERMOND M.D.

Provider Business Mailing Address
First Line	:	1101 MEDICARE CTR. 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 MEDICARE CTR. 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	:	03/30/2010
Last Update Date	:	04/29/2013

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