Provider Demographics
NPI:1477505071
Name:HOBBS MALUCCIO, MARY A (MD, MPH)
Entity type:Individual
Prefix:DR
First Name:MARY
Middle Name:A
Last Name:HOBBS MALUCCIO
Suffix:
Gender:F
Credentials:MD, MPH
Other - Prefix:
Other - First Name:MARY
Other - Middle Name:A
Other - Last Name:MALUCCIO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD, MPH
Mailing Address - Street 1:3621 LAKE DR
Mailing Address - Street 2:
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70002-1533
Mailing Address - Country:US
Mailing Address - Phone:462-671-6746
Mailing Address - Fax:
Practice Address - Street 1:4204 HOUMA BLVD
Practice Address - Street 2:
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70006-2903
Practice Address - Country:US
Practice Address - Phone:504-503-5426
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-16
Last Update Date:2024-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA3118612086X0206X
IN01059879A2086X0206X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086X0206XAllopathic & Osteopathic PhysiciansSurgerySurgical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000386156OtherANTHEM PIN
IN200308920Medicaid
IN200308920Medicaid
INI25009Medicare UPIN
IN233690PMedicare PIN