Individual
MARSHALL J. BYUN-ANDERSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1541 KINGS HIGHWAY, FAMILY MEDICINE, SHREVEPORT, LA 71130-3932
(318) 626-0014
Mailing address
1541 KINGS HIGHWAY, FAMILY MEDICINE, SHREVEPORT, LA 71130-3932
(318) 626-0014
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
330641
LA
207Q00000X
Family Medicine Physician
330641
LA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2497995
—
LA
Enumeration date
04/02/2019
Last updated
01/10/2023
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