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Individual

DAVID MICHAEL THERIOT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1111 MEDICAL CENTER BLVD STE 108, MARRERO, LA 70072-3152
(504) 349-1461
Mailing address
1111 MEDICAL CENTER BLVD STE 108, MARRERO, LA 70072-3152
(504) 349-1461

Taxonomy

Speciality
Code
Description
License number
State
2085N0700X
Neuroradiology Physician
320813
LA
2085R0202X
Diagnostic Radiology Physician
Primary
320813
LA

Other

Enumeration date
05/23/2014
Last updated
06/09/2020
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