Basic Information
Provider Information
NPI: 1497923957
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ECHEVERRI
FirstName: MICHELLE
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1430 TULANE AVE # SL79
Address2:  
City: NEW ORLEANS
State: LA
PostalCode: 701122632
CountryCode: US
TelephoneNumber: 5049882436
FaxNumber: 5049887389
Practice Location
Address1: 1430 TULANE AVE # SL79
Address2:  
City: NEW ORLEANS
State: LA
PostalCode: 701122632
CountryCode: US
TelephoneNumber: 5049882436
FaxNumber: 5049887389
Other Information
ProviderEnumerationDate: 02/18/2008
LastUpdateDate: 02/18/2008
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207ZP0102XGETP.TUL.PATLAY Allopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology

No ID Information.


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