Individual
MELINDA M PREVOST
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
8212 SUMMA AVE, BATON ROUGE, LA 70809-3421
(225) 769-4403
(225) 769-3842
Mailing address
7777 HENNESSY BLVD, STE 301, BATON ROUGE, LA 70808-0319
(225) 769-4403
(225) 769-3842
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
015076
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
015076
LA STATE MED LIC
LA
Enumeration date
02/19/2007
Last updated
07/18/2016
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