Individual
DR. WENDY SUDDETH GERVAIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
128 NEUROSCIENCE CT, GRAY, LA 70359-5209
(985) 917-3007
(985) 917-3010
Mailing address
PO BOX 4051, HOUMA, LA 70361-4051
(985) 917-3007
(985) 851-7526
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
MD.023887
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
48599
—
LA
Enumeration date
10/30/2006
Last updated
07/26/2016
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