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Organization

NORTHSHORE FAMILY MEDICINE, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
CHARLES BALETTE M.D. (OWNER)
(985) 875-9166
Entity
Organization

Contact information

Practice address
1119 S TYLER ST, COVINGTON, LA 70433-2327
(985) 875-9166
(985) 875-9170
Mailing address
1417 STILLWATER DR, MANDEVILLE, LA 70471-7452
(985) 875-9166

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary

Other

Enumeration date
02/22/2006
Last updated
10/29/2009
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