Individual
MASSIMO MORANDI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.FACS
Contact information
Practice address
1501 KINGS HWY, SHREVEPORT, LA 71103-4228
(318) 675-7636
Mailing address
1512 W KIRBY PL, SHREVEPORT, LA 71103-3822
(318) 675-7636
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
204269
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2133276
—
LA
01
—
4P921F600
MEDICARE - PTAN
LA
Enumeration date
12/01/2006
Last updated
05/11/2011
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