Provider Demographics
NPI:1407019888
Name:ENDOCRINOLOGY & DIABETES ASSOCIATES
Entity Type:Organization
Organization Name:ENDOCRINOLOGY & DIABETES ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:DR
Authorized Official - First Name:MARIDELI
Authorized Official - Middle Name:COLON
Authorized Official - Last Name:SCANLAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:504-393-0088
Mailing Address - Street 1:1111 MEDICAL CENTER BLVD N713
Mailing Address - Street 2:
Mailing Address - City:MARRERO
Mailing Address - State:LA
Mailing Address - Zip Code:70072
Mailing Address - Country:US
Mailing Address - Phone:504-393-0088
Mailing Address - Fax:504-393-0078
Practice Address - Street 1:1111 MEDICAL CENTER BLVD N713
Practice Address - Street 2:
Practice Address - City:MARRERO
Practice Address - State:LA
Practice Address - Zip Code:70072
Practice Address - Country:US
Practice Address - Phone:504-393-0088
Practice Address - Fax:504-393-0078
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-07
Last Update Date:2014-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA026390261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty