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Organization

SOUTH SHORE MEDICAL GROUP INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
ANDRIY MATROFAYLO (CEO)
(504) 885-0515
Entity
Organization

Contact information

Practice address
4515 SHORES DR, SUITE 100, METAIRIE, LA 70006-6808
(504) 885-0515
(504) 885-0517
Mailing address
4515 SHORES DR, SUITE 100, METAIRIE, LA 70006-6808
(504) 885-0515
(504) 885-0517

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary

Other

Enumeration date
06/29/2010
Last updated
06/29/2010
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