Individual
DWAN SHIRMELLE MABRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
15748 MEDICAL ARTS DR, HAMMOND, LA 70403-1446
(985) 542-0663
(985) 542-7010
Mailing address
15748 MEDICAL ARTS DR, HAMMOND, LA 70403-1446
(985) 542-0663
(985) 542-7010
Taxonomy
Speciality
Code
Description
License number
State
207VG0400X
Gynecology Physician
Primary
MD.022096
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1491853
—
LA
Enumeration date
06/28/2005
Last updated
09/19/2013
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