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Individual

DR. MICHAEL JOSEPH TORMA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
2530 BERT KOUNS INDUSTRIAL BLVD., SUITE 138, SHREVEPORT, LA 71118-6114
(318) 212-5911
(318) 212-5931
Mailing address
P.O. BOX 52569, SHREVEPORT, LA 71135-2569
(318) 212-5911
(318) 212-5931

Taxonomy

Speciality
Code
Description
License number
State
2083P0011X
Undersea and Hyperbaric Medicine (Preventive Medicine) Physician
Primary
12523R
LA
208600000X
Surgery Physician
12523R
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1159999
LA
01
810643587
CHAMPUS / TRICARE
LA
01
P00201070
RR MEDICARE
LA
01
P0020170
RAILROAD MEDICARE
LA
Enumeration date
06/13/2006
Last updated
10/27/2010
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