Organization
MAUREEN A OLIVIER M.D.
Active
Other names
OLIVIER DERMATOLOGY
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MAUREEN A OLIVIER M.D. (OWNER)
(337) 474-1386
Entity
Organization
Contact information
Practice address
4150 NELSON RD, BUILDING E SUITE 1, LAKE CHARLES, LA 70605-4140
(337) 474-1386
Mailing address
4150 NELSON RD, BUILDING E SUITE 1, LAKE CHARLES, LA 70605-4140
(337) 474-1386
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
015309
STATE LICENSE
LA
05
—
1300586
—
LA
01
—
54443
MEDICARE P-TAN
LA
Enumeration date
12/02/2015
Last updated
03/15/2016
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