Provider Demographics
NPI:1194777078
Name:INCER-OBANDO, MARIA A (MD)
Entity type:Individual
Prefix:DR
First Name:MARIA
Middle Name:A
Last Name:INCER-OBANDO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:139 CHAPEL HILL DR
Mailing Address - Street 2:
Mailing Address - City:BELLE CHASSE
Mailing Address - State:LA
Mailing Address - Zip Code:70037-1675
Mailing Address - Country:US
Mailing Address - Phone:504-505-3247
Mailing Address - Fax:
Practice Address - Street 1:139 CHAPEL HILL DR
Practice Address - Street 2:
Practice Address - City:BELLE CHASSE
Practice Address - State:LA
Practice Address - Zip Code:70037-1675
Practice Address - Country:US
Practice Address - Phone:504-505-3247
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-17
Last Update Date:2016-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY39095174400000X
NY003061207RE0101X
LA026646174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA2162373Medicaid
05912464OtherECFMG
NY02987002Medicaid
KYI36696Medicare UPIN
05912464OtherECFMG
LA4Q443Medicare PIN