Individual
JEROME CHARLES MAUTERER SR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CSTFA
Contact information
Practice address
490 MARINA DR, SLIDELL, LA 70458-9204
(985) 445-6902
Mailing address
490 MARINA DR, SLIDELL, LA 70458-9204
(985) 445-6902
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
—
—
363AS0400X
Surgical Physician Assistant
Primary
—
—
Other
Enumeration date
05/25/2010
Last updated
05/05/2026
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