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Individual

PETER N VLAHAKIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
2600 GREENWOOD RD, SHREVEPORT, LA 71103-3908
(318) 212-4000
Mailing address
643 MONROVIA ST, SHREVEPORT, LA 71106-1611
(318) 868-4709

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN042529 APO1669
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1900192
LA
Enumeration date
03/17/2006
Last updated
10/08/2008
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