Individual
MR. SEVERAN JOSEPH MEDINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
59690 BELLEVIEW DR, PLAQUEMINE, LA 70764-6501
(225) 687-7878
Mailing address
59690 BELLEVIEW DR, PLAQUEMINE, LA 70764-6501
(225) 687-7878
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
10295
LA
Other
Enumeration date
08/14/2014
Last updated
08/14/2014
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