Individual
BRYAN DAVID DIBUONO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1850 GAUSE BLVD E, SUITE 202, SLIDELL, LA 70461-5442
(985) 639-3777
Mailing address
1514 JEFFERSON HWY, SUITE 202, NEW ORLEANS, LA 70121-2429
(504) 842-4000
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
201223
LA
207RG0100X
Gastroenterology Physician
Primary
MD.201223
LA
390200000X
Student in an Organized Health Care Education/Training Program
201223
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
07582225
—
MS
05
—
1216801
—
LA
Enumeration date
08/05/2007
Last updated
04/07/2016
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