Healthcare Provider Details

I. General information

NPI: 1003243551
Provider Name (Legal Business Name): MAURICE DAVID GELDER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/30/2013
Last Update Date: 09/30/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5323 COLISEUM STREET
NEW ORLEANS LA
70115
US

IV. Provider business mailing address

5323 COLISEUM STREET
NEW ORLEANS LA
70115
US

V. Phone/Fax

Practice location:
  • Phone: 504-899-4160
  • Fax:
Mailing address:
  • Phone: 504-899-4160
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberMD011529
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: