Medaura, Juan
Medaura, Juan is an individual health care provider with primary practice located at 3525 Prytania St Ste 402 , New Orleans LA 70115-3585. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Nephrology, Student, Health Care / Student in an Organized Health Care Education/Training Program. Allopathic & Osteopathic Physicians / Nephrology is his primary health care specialty. Medaura, Juan can be contacted via phone (504) 648-2520.Contact Information
Primary practice address
3525 Prytania St Ste 402
New Orleans LA 70115-3585
Phone: (504) 648-2520
Fax: (504) 897-2939
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Nephrology | 207RN0300X | 330645 | Louisiana |
| Allopathic & Osteopathic Physicians / Nephrology | 207RN0300X | 24487 | Mississippi |
| Student, Health Care / Student in an Organized Health Care Education/Training Program | 390200000X |
Profile Details
| NPI number | 1114217189 |
|---|---|
| LBN Legal business name | Medaura, Juan |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 12th, 2011 |
| Last updated | Jun 1st, 2022 - about 4 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1114217189 | NPPES |
| Louisiana | MEDICAID | 2582445 | |
| Louisiana | Other | P01788687 | |
| Louisiana | MEDICAID | 07624070 |
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