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Organization
CAMELLIA CITY OBSTETRICS AND GYNECOLOGY
Active
Organization
CAMELLIA CITY OBSTETRICS AND GYNECOLOGY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DIANA CLAVIN MD (AUTHORIZED AGENT)
(985) 781-4848
Entity
Organization
Contact information
Practice address
1150 ROBERT BLVD, SUITE 360, SLIDELL, LA 70458-2004
(985) 781-4848
(985) 781-4850
Mailing address
1150 ROBERT BLVD, SUITE 360, SLIDELL, LA 70458-2004
(985) 781-4848
(985) 781-4850
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
90577
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2113381
—
LA
01
—
5U504DS23
MEDICARE LA LINKING NO. - ANN R. LOBELLO, MD
LA
01
—
5W897DS23
MEDICARE LA LINKING NO. DIANA K. CLAVIN, MD
LA
Enumeration date
08/09/2006
Last updated
02/24/2011
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