Individual
DR. PAUL MATTHEWS VAN DEVENTER
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2330 N CAUSEWAY BLVD, MANDEVILLE, LA 70471-6402
(985) 674-1700
(985) 674-1722
Mailing address
2330 N CAUSEWAY BLVD, MANDEVILLE, LA 70471-6402
(985) 674-1700
(985) 674-1722
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
10083R
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1531278
—
LA
Enumeration date
06/14/2005
Last updated
07/08/2007
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