Basic Information
| Provider Information | |||||||||
| NPI: | 1144354473 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ST. GERMAIN | ||||||||
| FirstName: | GERALDINE | ||||||||
| MiddleName: | ALBA | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4228 HOUMA BLVD | ||||||||
| Address2: | STE 410 | ||||||||
| City: | METAIRIE | ||||||||
| State: | LA | ||||||||
| PostalCode: | 700063021 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5048833770 | ||||||||
| FaxNumber: | 5048833711 | ||||||||
| Practice Location | |||||||||
| Address1: | 4228 HOUMA BLVD | ||||||||
| Address2: | STE 410 | ||||||||
| City: | METAIRIE | ||||||||
| State: | LA | ||||||||
| PostalCode: | 700063021 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5048833770 | ||||||||
| FaxNumber: | 5048833711 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/16/2007 | ||||||||
| LastUpdateDate: | 01/24/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207V00000X | 2008-01137 | NC | N | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | 207V00000X | 40544 | TN | N | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | 207V00000X | 203462 | LA | Y | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology |
ID Information
| ID | Type | State | Issuer | Description | 7809332 | 01 | CIGNA | OTHER | 3000130 | 05 | TN | MEDICAID | 4154127 | 01 | TN | BCBST | OTHER | 7012962 | 01 | AETNA HMO | OTHER | 09377061 | 05 | MS | MEDICAID | 5910195 | 05 | NC | MEDICAID | P00411147 | 01 | TN | RAILROAD MEDICARE | OTHER | 84617 | 01 | AR | BCBS AR | OTHER |