Individual
CHARLES RENE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3909 LAPALCO BLVD STE 200, HARVEY, LA 70058-2302
(504) 349-6216
Mailing address
149 W LAKEVIEW DR, LA PLACE, LA 70068-2427
(985) 651-7740
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
014495
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1355836
—
LA
Enumeration date
08/08/2006
Last updated
10/05/2011
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