Organization
CRITICAL CARE NEWBORN SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID MARK DE IULIO MD (PRESIDENT)
(337) 984-7828
Entity
Organization
Contact information
Practice address
1214 COOLIDGE BLVD, LAFAYETTE, LA 70503-2621
(337) 984-7828
(337) 984-7828
Mailing address
PO BOX 51393, LAFAYETTE, LA 70505-1393
(337) 984-7828
(337) 984-7828
Taxonomy
Speciality
Code
Description
License number
State
2080N0001X
Neonatal-Perinatal Medicine Physician
Primary
200453
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1041637
—
LA
Enumeration date
05/19/2006
Last updated
08/22/2020
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