Provider Demographics
NPI:1477843761
Name:GUIDER, JULIE C (MD)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:C
Last Name:GUIDER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1111 MEDICAL CENTER BLVD STE S450
Mailing Address - Street 2:
Mailing Address - City:MARRERO
Mailing Address - State:LA
Mailing Address - Zip Code:70072-3155
Mailing Address - Country:US
Mailing Address - Phone:504-349-6423
Mailing Address - Fax:504-349-6062
Practice Address - Street 1:2820 NAPOLEON AVE STE 720
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70115-8291
Practice Address - Country:US
Practice Address - Phone:504-896-8670
Practice Address - Fax:504-896-8699
Is Sole Proprietor?:No
Enumeration Date:2011-04-08
Last Update Date:2018-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA308535207RG0100X
TXR0404207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA2468961Medicaid