Individual
BENJAMIN M AZEVEDO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M. D., M. P H
Contact information
Practice address
1000 WALTERS ST, LAKE CHARLES, LA 70607-4647
(337) 480-8066
(337) 480-8061
Mailing address
PO BOX 122108 DEPT 2108, DALLAS, TX 75312-2108
(337) 494-2772
(337) 494-2928
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
305391
LA
Other
Enumeration date
05/22/2013
Last updated
02/03/2022
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