Healthcare Provider Details

I. General information

NPI: 1700818838
Provider Name (Legal Business Name): PAUL GREGORY HARCH MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/07/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1532 TULANE AVE
NEW ORLEANS LA
70112
US

IV. Provider business mailing address

PO BOX 740550
NEW ORLEANS LA
70174
US

V. Phone/Fax

Practice location:
  • Phone: 504-903-0698
  • Fax: 504-903-1325
Mailing address:
  • Phone: 504-366-7638
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207PE0005X
TaxonomyUndersea and Hyperbaric Medicine (Emergency Medicine) Physician
License Number06361R
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: