Organization
NORTHSHORE PLASTIC SURGERY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BENJAMIN J BOUDREAUX M.D. (MANAGER)
(225) 588-4644
Entity
Organization
Contact information
Practice address
3401 E CAUSEWAY APPROACH, MANDEVILLE, LA 70448-3447
(985) 237-6050
Mailing address
3401 E CAUSEWAY APPROACH, MANDEVILLE, LA 70448-3447
(985) 237-6050
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
MD.201940
LA
Other
Enumeration date
06/30/2009
Last updated
04/01/2021
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