Individual
IOANNIS A. MOISSIDIS
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
850 OLIVE ST, SUITE B, SHREVEPORT, LA 71104-2162
(318) 221-3584
(318) 227-9094
Mailing address
850 OLIVE ST, SUITE B, SHREVEPORT, LA 71104-2162
(318) 221-3584
(318) 227-9094
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
Primary
14718R
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1053716
—
LA
Enumeration date
09/29/2005
Last updated
07/08/2007
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