institution
Mg Desalvo Md&gm Gremillion Mdamc
Specialist in Metairie, Louisiana
NPI 1972623049

Mg Desalvo Md&gm Gremillion Mdamc is a Specialist based in Metairie, LA. Mg Desalvo Md&gm Gremillion Mdamc practices in Metairie, LA. The NPI Number for Mg Desalvo Md&gm Gremillion Mdamc is 1972623049 and holds a License No. 207Y00000X (Louisiana).

The current practice location address for Mg Desalvo Md&gm Gremillion Mdamc is 3645 Houma Blvd, Metairie, LA and can be reached out via phone at 504-885-4677 and via fax at 504-888-0549.

Location: 3645 Houma Blvd, Metairie, LA, 70006-4229
institution
Provider Profile Details
NPI Number
1972623049
Provider Name
Mg Desalvo Md&gm Gremillion Mdamc
Credential
Provider Entity Type
Organization
Address
3645 Houma Blvd, Metairie, LA, 70006-4229
Phone Number
504-885-4677
Fax Number
504-888-0549
Provider Enumeration Date
03/30/2007
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
1149179 05 LA
institution
Provider Business Practice Location Address Details
Address
3645 Houma Blvd
City
State
Zip
70006-4229
Phone Number
504-885-4677
Fax Number
504-888-0549
person
Provider Business Mailing Address Details
Address
3645 Houma Blvd
City
State
Zip
70006-4229
Phone Number
504-885-4677
Fax Number
504-888-0549
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Specialist
Speciality
-
Taxonomy
License No.
207Y00000X (Louisiana)
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
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