Healthcare Provider Details

I. General information

NPI: 1881700649
Provider Name (Legal Business Name): ANAND M IRIMPEN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/22/2006
Last Update Date: 04/27/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1415 TULANE AVE # TW15
NEW ORLEANS LA
70112-2600
US

IV. Provider business mailing address

1415 TULANE AVE # TW15
NEW ORLEANS LA
70112-2600
US

V. Phone/Fax

Practice location:
  • Phone: 504-988-6113
  • Fax: 504-988-7795
Mailing address:
  • Phone: 504-988-6113
  • Fax: 504-988-7795

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License NumberMD.09258R
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: