Healthcare Provider Details

I. General information

NPI: 1508285545
Provider Name (Legal Business Name): MARIA CHRISTINE CARRATOLA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/07/2014
Last Update Date: 03/30/2021
Certification Date: 03/30/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10310 THE GROVE BLVD
BATON ROUGE LA
70836-6455
US

IV. Provider business mailing address

10310 THE GROVE BLVD
BATON ROUGE LA
70836-6455
US

V. Phone/Fax

Practice location:
  • Phone: 225-761-5200
  • Fax:
Mailing address:
  • Phone: 225-761-5200
  • Fax: 225-761-5259

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207YP0228X
TaxonomyPediatric Otolaryngology Physician
License Number325650
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: