MEDICARE: DR. MUSTAFA HATIPOGLU 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	207RN0300X	Nephrology Physician	03798R	LA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	210915	OTHER	LA	COVENTRY
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	4028228	OTHER	LA	AETNA
4	496645410	OTHER	LA	BLUE CROSS OF LA.

General Provider Information

NPI Number	:	1699778118
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MUSTAFA HATIPOGLU M.D.

Provider Business Mailing Address
First Line	:	4424 CONLIN ST
Second Line	:	STE 2B
City	:	METAIRIE
State	:	LA
Zip	:	70006-2147
Country	:	US
Telephone Number	:	504-888-8717
Fax Number	:	504-888-8730

Provider Business Practice Location Address
First Line	:	4020 PARIS RD
Second Line	:
City	:	CHALMETTE
State	:	LA
Zip	:	70043-1362
Country	:	US
Telephone Number	:	504-277-8423
Fax Number	:	504-888-8730

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

Provider Enumeration Date	:	05/30/2005
Last Update Date	:	10/22/2008

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