MEDICARE: STEVEN M YOUNGBLOOD MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	200196	LA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MD200196	OTHER	LA	STATE MEDICAL LICENSE

General Provider Information

NPI Number	:	1053395988
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEVEN M YOUNGBLOOD MD

Provider Business Mailing Address
First Line	:	1523 SAINT CHARLES AVE
Second Line	:
City	:	NEW ORLEANS
State	:	LA
Zip	:	70130-4445
Country	:	US
Telephone Number	:	504-374-1000
Fax Number	:	504-374-1350

Provider Business Practice Location Address
First Line	:	1523 SAINT CHARLES AVE
Second Line	:
City	:	NEW ORLEANS
State	:	LA
Zip	:	70130-4445
Country	:	US
Telephone Number	:	504-374-1000
Fax Number	:	504-374-1350

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/05/2005
Last Update Date	:	06/05/2024

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Directions to “ STEVEN M YOUNGBLOOD MD” Practice Location

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