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Individual

DAVID F DIES

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D

Contact information

Practice address
3217 MABEL ST, SHREVEPORT, LA 71103-4022
(318) 631-9121
(318) 631-9126
Mailing address
3217 MABEL ST, SHREVEPORT, LA 71103-4022
(318) 631-9121
(318) 631-9126

Taxonomy

Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
019419
LA
207RT0003X
Transplant Hepatology Physician
Primary
019419
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1399493
LA
01
MD.019419
STATE LICENSE
LA
Enumeration date
10/27/2005
Last updated
08/11/2022
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