Provider Demographics
NPI:1225036833
Name:DISHMAN, NATALIE JUDE (MD)
Entity Type:Individual
Prefix:DR
First Name:NATALIE
Middle Name:JUDE
Last Name:DISHMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1126 MARGUERITE ST
Mailing Address - Street 2:
Mailing Address - City:MORGAN CITY
Mailing Address - State:LA
Mailing Address - Zip Code:70380-1854
Mailing Address - Country:US
Mailing Address - Phone:985-702-8500
Mailing Address - Fax:985-702-8507
Practice Address - Street 1:1126 MARGUERITE ST
Practice Address - Street 2:
Practice Address - City:MORGAN CITY
Practice Address - State:LA
Practice Address - Zip Code:70380-1854
Practice Address - Country:US
Practice Address - Phone:985-702-8500
Practice Address - Fax:985-702-8507
Is Sole Proprietor?:No
Enumeration Date:2005-07-08
Last Update Date:2011-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA024914207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1434205Medicaid
LA4F454CG71Medicare PIN
LAH94088Medicare UPIN