Healthcare Provider Details

I. General information

NPI: 1760167845
Provider Name (Legal Business Name): MATHILDA CAREW MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/16/2023
Last Update Date: 09/03/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

420 AVENUE F
BOGALUSA LA
70427-3634
US

IV. Provider business mailing address

420 AVENUE F
BOGALUSA LA
70427-3634
US

V. Phone/Fax

Practice location:
  • Phone: 985-730-6970
  • Fax:
Mailing address:
  • Phone: 985-730-6970
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberME182717
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number336860
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: