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Individual

MENCHU DE GUZMAN ONG

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
1501 KINGS HWY, DEPARTMENT OF PATHOLOGY, SHREVEPORT, LA 71103-4228
(318) 675-4557
(318) 675-7662
Mailing address
1501 KINGS HWY, DEPARTMENT OF PATHOLOGY, SHREVEPORT, LA 71103-4228
(318) 675-4557
(318) 675-7662

Taxonomy

Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
202630
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1356778
LA
Enumeration date
01/05/2009
Last updated
01/18/2012
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