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NPI Code Detail

MEDICARE: DR. EDWARD LARTEVI MD

MEDICARE: DR. EDWARD LARTEVI 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
1207P00000XEmergency Medicine Physician14217MS

General Provider Information

NPI Number : 1477576536
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. EDWARD LARTEVI MD
Provider Business Mailing Address
First Line : 1313 W SUNFLOWER RD
Second Line : #214
City : CLEVELAND
State : MS
Zip : 38732-2401
Country : US
Telephone Number : 504-242-9280
Fax Number : 727-507-3618
Provider Business Practice Location Address
First Line : 901 E SUNFLOWER RD
Second Line :
City : CLEVELAND
State : MS
Zip : 38732-2833
Country : US
Telephone Number : 662-846-2505
Fax Number : 662-846-2380
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/26/2006
Last Update Date : 04/08/2008

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Directions to “ DR. EDWARD LARTEVI MD” Practice Location

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