Organization
PELICAN IOM, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BERNIE MCHUGH M.D. (MANGER)
(225) 442-3549
Entity
Organization
Contact information
Practice address
7516 BLUEBONNET BLVD, PMB#166, BATON ROUGE, LA 70810-1627
(225) 442-3549
Mailing address
7516 BLUEBONNET BLVD, PMB#166, BATON ROUGE, LA 70810-1627
Taxonomy
Speciality
Code
Description
License number
State
204R00000X
Electrodiagnostic Medicine Physician
—
—
2084N0400X
Neurology Physician
—
—
2084N0600X
Clinical Neurophysiology Physician
Primary
—
—
246ZE0600X
Electroneurodiagnostic Specialist/Technologist
—
—
Other
Enumeration date
12/21/2015
Last updated
05/11/2017
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