Individual
MATTHEW ALBERT LAVALLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
211 SAINT FRANCIS DR, CAPE GIRARDEAU, MO 63703-5049
(573) 334-7575
(573) 334-7512
Mailing address
PO BOX 801143, KANSAS CITY, MO 64180-1143
(573) 331-5583
(573) 331-5079
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
2001002335
MO
207LC0200X
Critical Care Medicine (Anesthesiology) Physician
2001002335
MO
207LP2900X
Pain Medicine (Anesthesiology) Physician
2001002335
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
105181
BLUE CROSS BLUE SHIELD
MO
05
—
205317407
—
MO
01
—
461684
HEALTHLINK
—
Enumeration date
08/30/2006
Last updated
08/01/2023
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