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Individual

DR. DAVID MICHAEL GRACE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
110 QUEEN OF PEACE DR, LAFAYETTE, LA 70508-5383
(337) 354-1185
Mailing address
200 CORPORATE BLVD, STE 201, LAFAYETTE, LA 70508-3870
(337) 354-1185

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
200024
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1575461
LA
Enumeration date
06/01/2005
Last updated
06/11/2013
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