Healthcare Provider Details

I. General information

NPI: 1497162309
Provider Name (Legal Business Name): DANUEL LAAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/14/2014
Last Update Date: 07/23/2020
Certification Date: 07/23/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1415 TULANE AVE
NEW ORLEANS LA
70112-2600
US

IV. Provider business mailing address

1430 TULANE AVE # 8622
NEW ORLEANS LA
70112-2632
US

V. Phone/Fax

Practice location:
  • Phone: 504-988-5263
  • Fax:
Mailing address:
  • Phone: 504-988-5128
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number323135
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: