Individual
DR. SHAWN MORETA HUMPHRIES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
200 W 134TH PL, CUT OFF, LA 70345-4143
(985) 632-8256
(985) 325-8417
Mailing address
4104 CHATEAU BLVD, CONDO C, KENNER, LA 70065-5721
(504) 464-7557
(985) 325-8417
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
06675R
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1355739
—
LA
Enumeration date
09/16/2006
Last updated
07/08/2007
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