Healthcare Provider Details
I. General information
NPI: 1821181942
Provider Name (Legal Business Name): MIGUEL MELGAR MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 10/02/2006
Last Update Date: 03/26/2013
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
131 S ROBERTSON ST SUITE 1300
NEW ORLEANS LA
70112-2807
US
V. Phone/Fax
- Phone: 504-988-2300
- Fax: 504-988-8886
- Phone: 504-352-1924
- Fax: 504-988-5793
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207T00000X |
| Taxonomy | Neurological Surgery Physician |
| License Number | 14936R |
| License Number State | LA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: