Organization
SOUTHSHORE LUNG CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MATTHEW L SCHUETTE MD (OWNER)
(504) 456-7456
Entity
Organization
Contact information
Practice address
4224 HOUMA BLVD, SUITE 600, METAIRIE, LA 70006-2933
(504) 456-7456
(504) 456-7453
Mailing address
4224 HOUMA BLVD, SUITE 600, METAIRIE, LA 70006-2933
(504) 456-7456
(504) 456-7453
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
019956
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5C518
MEDICARE PTAN
LA
Enumeration date
06/22/2006
Last updated
12/09/2009
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