Individual
ALLAN S MATRIANO LIM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
8001 YOUREE DR, SUITE 720, SHREVEPORT, LA 71115-2302
(318) 798-9881
(318) 798-9979
Mailing address
8001 YOUREE DR, SUITE 720, SHREVEPORT, LA 71115-2302
(318) 798-9881
(318) 798-9979
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
021617
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1682411
—
LA
Enumeration date
10/13/2005
Last updated
03/30/2011
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