Provider Demographics
NPI:1376570069
Name:WORKMAN, MARK B (MD)
Entity Type:Individual
Prefix:MR
First Name:MARK
Middle Name:B
Last Name:WORKMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:ONE GALLERIA BLVD.
Mailing Address - Street 2:SUITE 1200
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70001
Mailing Address - Country:US
Mailing Address - Phone:504-717-5202
Mailing Address - Fax:
Practice Address - Street 1:ONE GALLERIA BLVD.
Practice Address - Street 2:SUITE 1200
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70001
Practice Address - Country:US
Practice Address - Phone:504-717-5202
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2016-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA05461R207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1316431Medicaid
LA1316431Medicaid
LA5L4037345Medicare PIN
LA1316431Medicaid