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Individual

DR. BRUCE J ITELD

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD,FACC,FCCP,FSCAI

Contact information

Practice address
1810 LINDBERG DR STE 2100, SLIDELL, LA 70458-8064
(985) 649-2700
(985) 649-2950
Mailing address
PO BOX 2209, SLIDELL, LA 70459-2209
(985) 649-2700
(985) 649-2950

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
012398
LA
207RC0000X
Cardiovascular Disease Physician
012398
LA
207RI0011X
Interventional Cardiology Physician
012398
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1136425
LA
Enumeration date
06/22/2006
Last updated
11/24/2023
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