Provider Demographics
NPI:1548231020
Name:METCALF, GENESA GAROFALO (MD)
Entity Type:Individual
Prefix:
First Name:GENESA
Middle Name:GAROFALO
Last Name:METCALF
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:GENESA
Other - Middle Name:NATALIE
Other - Last Name:WILLIAMS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:1514 JEFFERSON HIGHWAY
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70121
Mailing Address - Country:US
Mailing Address - Phone:504-842-4000
Mailing Address - Fax:
Practice Address - Street 1:41676 VETERANS AVENUE
Practice Address - Street 2:
Practice Address - City:HAMMOND
Practice Address - State:LA
Practice Address - Zip Code:70403
Practice Address - Country:US
Practice Address - Phone:985-543-3600
Practice Address - Fax:985-542-7571
Is Sole Proprietor?:No
Enumeration Date:2006-01-31
Last Update Date:2019-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALAL24360207Q00000X
LAMD.202918207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS01203510Medicaid
080194358OtherRAILROAD MEDICARE
LA1894109Medicaid
AL246360OtherALABAMA MEDICAL LICENCE
AL246360OtherALABAMA MEDICAL LICENCE
ALH78882Medicare UPIN
LA4M328Medicare PIN
LA4M3287061Medicare PIN