Provider Demographics
NPI:1811183627
Name:CARTAGENA, MARIA IVELISSE (MD)
Entity type:Individual
Prefix:DR
First Name:MARIA
Middle Name:IVELISSE
Last Name:CARTAGENA
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 1:4228 HOUMA BLVD STE 200
Mailing Address - Street 2:
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70006-3004
Mailing Address - Country:US
Mailing Address - Phone:504-454-7878
Mailing Address - Fax:
Practice Address - Street 1:4228 HOUMA BLVD STE 200
Practice Address - Street 2:
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70006-3004
Practice Address - Country:US
Practice Address - Phone:504-454-7878
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-09-15
Last Update Date:2007-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAGETP.EJGH.FP207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine