Provider Demographics
NPI:1942205927
Name:RALPH SAGREAR,MD & BAPTISTE W. BRUNNER, MD, APMC
Entity Type:Organization
Organization Name:RALPH SAGREAR,MD & BAPTISTE W. BRUNNER, MD, APMC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY/TREASURER
Authorized Official - Prefix:DR
Authorized Official - First Name:BAPTISTE
Authorized Official - Middle Name:W
Authorized Official - Last Name:BRUNNER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:504-277-8265
Mailing Address - Street 1:PO BOX 8815
Mailing Address - Street 2:
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70011-8815
Mailing Address - Country:US
Mailing Address - Phone:504-277-8265
Mailing Address - Fax:504-277-0020
Practice Address - Street 1:800 W VIRTUE ST
Practice Address - Street 2:STE 204
Practice Address - City:CHALMETTE
Practice Address - State:LA
Practice Address - Zip Code:70043-1292
Practice Address - Country:US
Practice Address - Phone:504-277-8265
Practice Address - Fax:504-277-0020
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA0040046208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA5B451Medicare ID - Type Unspecified