Provider Demographics
NPI:1114055548
Name:BAUDIER, MARY MADONNA (MD)
Entity Type:Individual
Prefix:DR
First Name:MARY
Middle Name:MADONNA
Last Name:BAUDIER
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:3525 PRYTANIA ST
Mailing Address - Street 2:SUITE #620
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70115-3500
Mailing Address - Country:US
Mailing Address - Phone:504-897-4425
Mailing Address - Fax:504-301-3759
Practice Address - Street 1:3525 PRYTANIA ST
Practice Address - Street 2:SUITE #620
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70115-3500
Practice Address - Country:US
Practice Address - Phone:504-897-4425
Practice Address - Fax:504-301-3759
Is Sole Proprietor?:No
Enumeration Date:2007-02-28
Last Update Date:2007-07-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
LA012112207QA0505X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1332658Medicaid
LA50342Medicare ID - Type UnspecifiedMEDICARE
LAD79747Medicare UPIN