Organization
CHILDRENS MEDICAL CLINIC INC
Active
Parent organization
CHILDREN'S MEDICAL CLINIC, INC.
Organization subpart
Yes
Provider details
NPI number
Legal business name
CHILDREN'S MEDICAL CLINIC, INC.
Authorized official
ROSELYN ST ETIENNE MD (PHYSICIAN)
(504) 582-9922
Entity
Organization
Contact information
Practice address
4701 WESTBANK EXPY STE 7, MARRERO, LA 70072-3050
(504) 582-9922
(504) 582-9928
Mailing address
4701 WESTBANK EXPY STE 7, MARRERO, LA 70072-3050
(504) 582-9922
(504) 582-9928
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1446319
—
LA
05
—
1564362
—
LA
Enumeration date
03/13/2007
Last updated
08/01/2022
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