Individual
MARIANA MARRERO CASTILLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1541 KINGS HWY, SHREVEPORT, LA 71103-4228
(318) 626-0000
(318) 629-4833
Mailing address
1512 W KIRBY PL, SHREVEPORT, LA 71103-3822
(318) 626-0177
(318) 629-4833
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
328295
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036151524
—
IL
Enumeration date
07/07/2016
Last updated
12/28/2022
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