Individual
DR. ROY DIVITTORIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
15837 PAUL VEGA MD DR, SUITE 200, HAMMOND, LA 70403-1462
(985) 542-8190
(985) 543-0031
Mailing address
PO BOX 2277, HAMMOND, LA 70404-2277
(985) 542-8190
(985) 543-0031
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
MD14045R
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00938732
—
MS
05
—
1577103
—
LA
Enumeration date
11/02/2005
Last updated
07/18/2011
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