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Individual

DR. CYRIL MALVIN SCULLY JR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DPM

Contact information

Practice address
3510 SEVERN AVE, METAIRIE, LA 70002-3444
(504) 455-1777
(504) 455-5361
Mailing address
3510 SEVERN AVE, METAIRIE, LA 70002-3444
(504) 455-1777
(504) 455-5361

Taxonomy

Speciality
Code
Description
License number
State
213ES0131X
Foot Surgery Podiatrist
Primary
PD006R
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1397679
LA
Enumeration date
08/18/2005
Last updated
04/30/2008
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