Healthcare Provider Details
I. General information
NPI: 1083913479
Provider Name (Legal Business Name): MARY SAWLAI HOANG MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 03/24/2011
Last Update Date: 11/26/2024
Certification Date: 11/26/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2820 NAPOLEON AVE
NEW ORLEANS LA
70115-6969
US
IV. Provider business mailing address
1514 JEFFERSON HWY
NEW ORLEANS LA
70121-2429
US
V. Phone/Fax
- Phone: 504-842-4250
- Fax:
- Phone: 504-842-4000
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | 344486 |
| License Number State | LA |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | 2015010244 |
| License Number State | MO |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: