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Individual

MICHAEL WAYNE FUSILIER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
800 E MAIN ST, VILLE PLATTE, LA 70586-4618
(337) 468-2767
(337) 468-4170
Mailing address
PO BOX 120, MAMOU, LA 70554-0120
(337) 468-2767
(337) 468-4170

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
AP02020
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1390879
LA
Enumeration date
01/04/2007
Last updated
10/18/2010
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