MEDICARE: DR. LANDER LAVERN PEARCE 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	2471M1202X	Magnetic Resonance Imaging Radiologic Technologist	M.D.010815	LA

General Provider Information

NPI Number	:	1841749819
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LANDER LAVERN PEARCE M.D.

Provider Business Mailing Address
First Line	:	2700 CADIZ ST
Second Line	:
City	:	NEW ORLEANS
State	:	LA
Zip	:	70115-6930
Country	:	US
Telephone Number	:	504-891-1975
Fax Number	:

Provider Business Practice Location Address
First Line	:	2700 CADIZ ST
Second Line	:
City	:	NEW ORLEANS
State	:	LA
Zip	:	70115-6930
Country	:	US
Telephone Number	:	504-891-1975
Fax Number	:

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

Provider Enumeration Date	:	09/30/2016
Last Update Date	:	09/30/2016

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