Individual
PETER STEVENS FAIL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
225 DUNN ST, HOUMA, LA 70360
(985) 876-0300
(985) 872-0317
Mailing address
225 DUNN ST, HOUMA, LA 70360-4440
(985) 876-0300
(985) 872-0317
Taxonomy
Speciality
Code
Description
License number
State
207RA0001X
Advanced Heart Failure and Transplant Cardiology Physician
Primary
11924R
LA
207RC0000X
Cardiovascular Disease Physician
11924R
LA
207RI0011X
Interventional Cardiology Physician
11924R
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
060042304
RR MEDICARE
LA
05
—
1681784
—
LA
Enumeration date
07/05/2005
Last updated
07/05/2018
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