Individual
DR. MATTHEW BRUCE CHAMBERLAIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5428 ODONOVAN DR STE B, BATON ROUGE, LA 70808-4387
(225) 330-0480
(225) 330-0482
Mailing address
12525 PERKINS RD, SUITE A, BATON ROUGE, LA 70810-1907
(225) 765-4256
(225) 765-4034
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD.14168R
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1107361
—
LA
01
—
P00067617
RAILROAD MEDICARE
LA
01
—
P00215586
RRM
LA
Enumeration date
11/22/2005
Last updated
02/03/2021
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