Provider Demographics
NPI:1972724698
Name:BEZDEK, RACHEL DELATTE (MD)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:DELATTE
Last Name:BEZDEK
Suffix:
Gender:F
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 RUE DE SANTE
Mailing Address - Street 2:
Mailing Address - City:LA PLACE
Mailing Address - State:LA
Mailing Address - Zip Code:70068-5404
Mailing Address - Country:US
Mailing Address - Phone:985-652-2441
Mailing Address - Fax:
Practice Address - Street 1:301 RUE DE SANTE
Practice Address - Street 2:
Practice Address - City:LA PLACE
Practice Address - State:LA
Practice Address - Zip Code:70068-5404
Practice Address - Country:US
Practice Address - Phone:985-652-2441
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-01
Last Update Date:2009-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAMD.202872207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1887561Medicaid
LA1887561Medicaid
LA4M285Medicare PIN