Individual
GERARD ANTHONY BERTOLINO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1990 INDUSTRIAL BLVD, HOUMA, LA 70363-7055
(985) 868-9300
(985) 851-0053
Mailing address
1990 INDUSTRIAL BLVD, HOUMA, LA 70363-7055
(985) 868-9300
(985) 851-0053
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
H6772
TX
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
MD.017641
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1773387
—
LA
01
—
220009432
RAILROAD M/C-NEPG
TX
01
—
220018816
RAILROAD MEDICARE
TX
Enumeration date
06/13/2005
Last updated
10/18/2016
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