Healthcare Provider Details

I. General information

NPI: 1184717498
Provider Name (Legal Business Name): MYRA ANNETTE KLEINPETER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/02/2006
Last Update Date: 03/18/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1415 TULANE AVE
NEW ORLEANS LA
70112-2600
US

IV. Provider business mailing address

1430 TULANE AVE TW22
NEW ORLEANS LA
70112-2632
US

V. Phone/Fax

Practice location:
  • Phone: 504-988-2300
  • Fax: 504-988-7691
Mailing address:
  • Phone: 504-988-2300
  • Fax: 504-988-7691

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number020348
License Number StateLA
# 2
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number020348
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: