Provider Demographics
NPI:1629538996
Name:DILLS, MADELINE MOORE (MD)
Entity Type:Individual
Prefix:DR
First Name:MADELINE
Middle Name:MOORE
Last Name:DILLS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MADELINE
Other - Middle Name:CELESTE
Other - Last Name:MOORE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1542 TULANE AVE RM 734B
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70112-2865
Mailing Address - Country:US
Mailing Address - Phone:504-568-4748
Mailing Address - Fax:
Practice Address - Street 1:433 BOLIVAR ST
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70112
Practice Address - Country:US
Practice Address - Phone:504-568-4748
Practice Address - Fax:504-568-4633
Is Sole Proprietor?:No
Enumeration Date:2019-03-22
Last Update Date:2019-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program