Healthcare Provider Details

I. General information

NPI: 1760426035
Provider Name (Legal Business Name): VIVEK RAMESH HUILGOL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/16/2006
Last Update Date: 11/04/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3715 PRYTANIA ST SUITE 500
NEW ORLEANS LA
70115-3761
US

IV. Provider business mailing address

1427 8TH ST
NEW ORLEANS LA
70115-3336
US

V. Phone/Fax

Practice location:
  • Phone: 415-999-1460
  • Fax:
Mailing address:
  • Phone: 415-999-1460
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number11292
License Number StateNV
# 2
Primary TaxonomyN
Taxonomy Code207RI0008X
TaxonomyHepatology Physician
License Number11292
License Number StateNV
# 3
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License NumberMD.12692R
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: