Individual
LEYAMMA MATHEW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
721 E HIGHWAY 30, GONZALES, LA 70737-4715
(225) 644-7337
(225) 644-5202
Mailing address
721 E HIGHWAY 30, GONZALES, LA 70737-4715
(225) 644-7337
(225) 644-5202
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
04797R
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1310344
—
LA
Enumeration date
08/30/2005
Last updated
09/01/2011
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