MEDICARE: DR. NANCY S VANDER VELDE M.D.

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	D58947	MD
2	207RX0202X	Medical Oncology Physician	D58947	MD

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	P00136883	OTHER	MD	R/R MEDICARE PROVIDER #
3	C31152	OTHER	MD	R/R MEDICARE GROUP #

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

General Provider Information

NPI Number	:	1235172511
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NANCY S VANDER VELDE M.D.

Provider Business Mailing Address
First Line	:	1601 PERDIDO ST
Second Line	:	ATTN: MEDICINE OFFICE
City	:	NEW ORLEANS
State	:	LA
Zip	:	70112-1262
Country	:	US
Telephone Number	:	504-553-2143
Fax Number	:	504-553-2113

Provider Business Practice Location Address
First Line	:	1601 PERDIDO ST
Second Line	:	ATTN: MEDICINE OFFICE
City	:	NEW ORLEANS
State	:	LA
Zip	:	70112-1262
Country	:	US
Telephone Number	:	504-553-2143
Fax Number	:	504-553-2113

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

Provider Enumeration Date	:	06/14/2006
Last Update Date	:	08/16/2011

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Directions to “ DR. NANCY S VANDER VELDE M.D.” Practice Location

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