Individual
DR. MARY COENEN RAVEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
4950 ESSEN LN STE 503, BATON ROUGE, LA 70809-3738
(225) 765-1737
(225) 765-1842
Mailing address
5959 S SHERWOOD FOREST BLVD, BATON ROUGE, LA 70816-6038
(225) 526-0177
(225) 765-9196
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
200349
LA
207RH0002X
Hospice and Palliative Medicine (Internal Medicine) Physician
200349
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
05823364
—
MS
05
—
1066991
—
LA
Enumeration date
08/06/2007
Last updated
05/27/2021
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