| Redimed | |
|
4430 Hwy 22 Mandeville LA 70471 | |
| (985) 626-3470 | |
| (985) 674-5377 |
| Full Name | Redimed |
|---|---|
| Speciality | Family Medicine |
| Location | 4430 Hwy 22, Mandeville, Louisiana |
| Authorized Official Name and Position | Alessa E Fabre (PRACTICE ADMINISTRATOR) |
| Authorized Official Contact | 9856263470 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Redimed 4430 Hwy 22 Mandeville LA 70471 Ph: (985) 626-3470 | Redimed 4430 Hwy 22 Mandeville LA 70471 Ph: (985) 626-3470 |
| NPI Number | 1295050599 |
|---|---|
| Provider Enumeration Date | 03/30/2010 |
| Last Update Date | 10/12/2017 |
| Medicare PECOS PAC ID | 2163609660 |
|---|---|
| Medicare Enrollment ID | O20110610000009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295050599 | NPI | - | NPPES |
| 2167529 | Medicaid | LA | |
| 1652539 | Medicaid | LA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 10199R (Louisiana) | Primary |
| Provider Name | Mohammad Naeem |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1235172354 PECOS PAC ID: 0345146478 Enrollment ID: I20031210000269 |
| Provider Name | Mohammed Yousuf |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1487686275 PECOS PAC ID: 3577589795 Enrollment ID: I20051018000205 |
| Provider Name | Tuan B Nguyen |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1366633182 PECOS PAC ID: 8325195746 Enrollment ID: I20090421000706 |
| Provider Name | Mohammad Imran Naeem |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1811253420 PECOS PAC ID: 6305123811 Enrollment ID: I20170608002487 |
| Provider Name | Charlotte Michelle Fuller |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033657580 PECOS PAC ID: 6800164849 Enrollment ID: I20170616000937 |
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