Individual
MADAELIL GEORGE THOMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1150 ROBERT BLVD, SUITE 340, SLIDELL, LA 70458-2004
(985) 649-2883
(985) 649-2953
Mailing address
1150 ROBERT BLVD, SUITE 340, SLIDELL, LA 70458-2004
(985) 649-2883
(985) 649-2953
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
05592R
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1316067
—
LA
Enumeration date
05/24/2005
Last updated
04/13/2009
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