Provider Demographics
NPI:1063603330
Name:BULLER, GABY BRIGITTE (MD)
Entity type:Individual
Prefix:DR
First Name:GABY
Middle Name:BRIGITTE
Last Name:BULLER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2020 GRAVIER ST FL 7
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70112-2272
Mailing Address - Country:US
Mailing Address - Phone:504-903-5022
Mailing Address - Fax:504-903-5026
Practice Address - Street 1:2020 GRAVIER ST FL 7
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70112-2272
Practice Address - Country:US
Practice Address - Phone:504-903-5022
Practice Address - Fax:504-903-5026
Is Sole Proprietor?:No
Enumeration Date:2007-08-01
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAPGY.1.LSUNO-EMR207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1005088Medicaid
LA1005088Medicaid