Individual
DR. PETER WYNHOVEN SIMONEAUX
Active
Individual
DR. PETER WYNHOVEN SIMONEAUX
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
018423
LA
207ND0101X
MOHS-Micrographic Surgery Physician
018423
LA
207ND0101X
MOHS-Micrographic Surgery Physician
Primary
MD.018423
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00119119
MEDICAID
MS
05
—
1381454
—
LA
01
—
P00033629
RR MEDICARE
LA
Enumeration date
05/04/2006
Last updated
05/28/2014
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