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General NPI Number Information
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NPI Number | 1295994218
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Entity Type | Individual
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Provider Name | ANDREA TESVICH MURINA M.D.
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Gender | Female
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Dates
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Enumeration Date | 06/05/2008
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Last Update Date | 10/22/2012
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Provider Practice Location Address
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Address Line | 1430 TULANE AVE # 8036
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City | NEW ORLEANS
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State | LA
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Zip | 70112-2632
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Country | US
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Telephone | 504-988-5114
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Fax | 504-988-7328
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Provider Business Mailing Address
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Address Line | 144 PLANTERS CANAL RD
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City | BELLE CHASSE
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State | LA
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Zip | 70037-1230
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Country | US
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Telephone | 504-392-7225
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207NI0002X
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Taxonomy Name | Clinical & Laboratory Dermatological Immunology Physician
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License Number | MD202960
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License Number State | LA
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