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Individual

MR. ANGELO PAUL MORREALE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DPM

Contact information

Practice address
725 N ASHLEY RIDGE LOOP, SUITE 200, SHREVEPORT, LA 71106-7232
(318) 797-3668
(318) 797-7977
Mailing address
PO BOX 52313, SHREVEPORT, LA 71135-2313
(318) 797-3668
(318) 797-7977

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
PDO64R
LA
213EP1101X
Primary Podiatric Medicine Podiatrist
DPMPDO64R
LA
213ER0200X
Radiology Podiatrist
DPMPDO64R
LA
213ES0000X
Sports Medicine Podiatrist
DPMPDO64R
LA
213ES0103X
Foot & Ankle Surgery Podiatrist
DPMPDO64R
LA
213ES0131X
Foot Surgery Podiatrist
DPMPDO64R
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1905801
LA
Enumeration date
04/12/2006
Last updated
01/27/2017
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