Organization
SOUTHERN NEUROMONITORING, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DANI BIDROS M.D. (PRESIDENT)
(225) 442-3582
Entity
Organization
Contact information
Practice address
7516 BLUEBONNET BLVD # 135, BATON ROUGE, LA 70810-1627
(225) 442-3582
Mailing address
7516 BLUEBONNET BLVD # 135, BATON ROUGE, LA 70810-1627
Taxonomy
Speciality
Code
Description
License number
State
204R00000X
Electrodiagnostic Medicine Physician
—
—
2084N0400X
Neurology Physician
—
—
2084N0600X
Clinical Neurophysiology Physician
Primary
—
—
246ZE0600X
Electroneurodiagnostic Specialist/Technologist
—
—
Other
Enumeration date
02/13/2017
Last updated
02/13/2017
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