Individual
RAYMOND DEWIE GERMANY JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
255 BERT KOUNS LOOP, SHREVEPORT, LA 71106-8150
(318) 683-0411
(318) 603-5461
Mailing address
255 BERT KOUNS LOOP, SHREVEPORT, LA 71106-8150
(318) 683-0411
(318) 603-5461
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
020129
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1963054
—
LA
01
—
340012712
RAILROAD MEDICARE
LA
Enumeration date
06/20/2005
Last updated
04/01/2010
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