Provider Demographics
NPI:1659376895
Name:NOREM, RICHARD F II (MD)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:F
Last Name:NOREM
Suffix:II
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 4TH ST
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:LA
Mailing Address - Zip Code:71301-8423
Mailing Address - Country:US
Mailing Address - Phone:318-448-1040
Mailing Address - Fax:318-448-0548
Practice Address - Street 1:301 4TH ST
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:LA
Practice Address - Zip Code:71301-8423
Practice Address - Country:US
Practice Address - Phone:318-448-1040
Practice Address - Fax:318-448-0548
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-15
Last Update Date:2008-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA020067208600000X
TXJ3862208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1988782Medicaid
LAF59734Medicare UPIN
LA5U546Medicare PIN