Individual
DR. MICHAEL DEWITT TEAGUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5000 HENNESSY BLVD, BATON ROUGE, LA 70808-4375
(225) 765-4050
(225) 765-4046
Mailing address
5959 S SHERWOOD FOREST BLVD, BATON ROUGE, LA 70816-6038
(225) 765-4050
(225) 765-9196
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
022014
LA
208M00000X
Hospitalist Physician
Primary
022014
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02722201
—
MS
05
—
1679755
—
LA
01
—
P00020214
RAIL ROAD MEDICARE
LA
Enumeration date
08/03/2005
Last updated
10/06/2023
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