Individual
MARCELLE MARIE ROUSSEAU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2021 PERDIDO ST, MEDICAL HOME CLINIC, NEW ORLEANS, LA 70112-1352
(504) 903-3000
(504) 903-5157
Mailing address
2021 PERDIDO ST, MEDICAL HOME CLINIC, NEW ORLEANS, LA 70112-1352
(504) 903-3000
(504) 903-5157
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
200431
LA
208000000X
Pediatrics Physician
200431
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1-07388-1
—
LA
Enumeration date
08/07/2007
Last updated
02/18/2013
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