Individual
MARC DENNIS BREEHL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
510 E STONER AVE, SHREVEPORT, LA 71101-4243
(318) 221-8411
(318) 990-5710
Mailing address
104 CALAIS CT, BOSSIER CITY, LA 71111-5482
(318) 347-8129
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
206991
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100065320A
—
OK
05
—
175924301
—
TX
01
—
8G1548
BCBSTX
TX
Enumeration date
04/18/2006
Last updated
05/26/2016
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