Individual
MR. MATTHEW EARLES DAUTERIVE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2309 E MAIN ST STE 500, NEW IBERIA, LA 70560-4046
(337) 374-7315
(337) 374-7313
Mailing address
155 HOSPITAL DR STE 101, LAFAYETTE, LA 70503-2852
(252) 744-5258
(252) 744-4887
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
308116
LA
Other
Enumeration date
05/02/2012
Last updated
07/17/2023
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