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MARCO QUISPE LEVEAU

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1501 KINGS HWY, DEPARTMENT OF MEDICINE, SHREVEPORT, LA 71103-4228
(318) 675-5000
Mailing address
1512 W KIRBY PL, SHREVEPORT, LA 71103-3822
(318) 675-5000

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
MD.206784
LA
2080P0203X
Pediatric Critical Care Medicine Physician
MD.206784
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1509761
LA
Enumeration date
07/30/2007
Last updated
10/09/2014
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