Angelico, Blaise Andrew

Angelico, Blaise Andrew is an individual health care provider with primary practice located at 4228 Houma Blvd Ste 400, Metairie LA 70006-3000. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Angelico, Blaise Andrew can be contacted via phone (504) 456-5123.

Contact Information

Primary practice address
4228 Houma Blvd Ste 400 Metairie LA 70006-3000
Phone: (504) 456-5123
Fax: (504) 456-5129
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X MD014132 Louisiana

Profile Details

NPI number 1053363754
LBN Legal business name Angelico, Blaise Andrew
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 17th, 2006
Last updated Dec 21st, 2012 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1053363754 NPPES
Louisiana MEDICAID 1199508
Louisiana Other 5M214

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