Individual
DR. ANDRE FUNDERBURK GUIDRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
291 LIBERTY ST, HOUMA, LA 70360-4423
(985) 868-7882
Mailing address
291 LIBERTY ST, HOUMA, LA 70360-4423
(985) 868-7882
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD200525
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4K610F991
PTAN
LA
Enumeration date
01/12/2007
Last updated
04/24/2008
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