Individual
DR. CHAD BENJAMIN VANASSELBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1203 S TYLER ST, SUITE 200, COVINGTON, LA 70433
(985) 892-9143
(985) 892-9656
Mailing address
1203 S TYLER ST, SUITE 200, COVINGTON, LA 70433-2353
(985) 892-9143
(985) 892-9656
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
T-1994
MS
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
206801
LA
207RP1001X
Pulmonary Disease Physician
Primary
206801
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2357620
—
LA
Enumeration date
07/05/2007
Last updated
07/10/2018
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