Healthcare Provider Details

I. General information

NPI: 1629137781
Provider Name (Legal Business Name): ANTHONY MICHAEL DIGIORGIO DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/06/2006
Last Update Date: 04/28/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2020 GRAVIER ST 7TH FLOOR
NEW ORLEANS LA
70112-2272
US

IV. Provider business mailing address

2020 GRAVIER ST 7TH FLOOR
NEW ORLEANS LA
70112-2272
US

V. Phone/Fax

Practice location:
  • Phone: 504-568-6123
  • Fax: 504-568-6127
Mailing address:
  • Phone: 504-568-6123
  • Fax: 504-568-6127

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code246ZE0600X
TaxonomyElectroneurodiagnostic Specialist/Technologist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: