Organization
CAMELLIA CITY OBSTETRICS AND GYNECOLOGY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DIANA CLAVIN MD (AUTHORIZED AGENT)
(985) 781-4848
Entity
Organization
Contact information
Practice address
1150 ROBERT BLVD, SUITE 360, SLIDELL, LA 70458-2004
(985) 781-4848
(985) 781-4850
Mailing address
1150 ROBERT BLVD, SUITE 360, SLIDELL, LA 70458-2004
(985) 781-4848
(985) 781-4850
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
90577
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2113381
—
LA
01
—
5U504DS23
MEDICARE LA LINKING NO. - ANN R. LOBELLO, MD
LA
01
—
5W897DS23
MEDICARE LA LINKING NO. DIANA K. CLAVIN, MD
LA
Enumeration date
08/09/2006
Last updated
02/24/2011
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