Individual
SCOTT A CARBAJAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1800 RYAN ST, SUITE 105, LAKE CHARLES, LA 70601-6078
(337) 439-4706
(337) 439-8110
Mailing address
555 E. CHEVES ST., ATTN RADIOLOGY DEPARTMENT, FLORENCE, SC 29506-2617
(843) 777-2879
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
023592
LA
2085R0202X
Diagnostic Radiology Physician
19262
MS
2085R0202X
Diagnostic Radiology Physician
27613
SC
2085R0202X
Diagnostic Radiology Physician
Primary
MD.023592
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1483451
—
LA
Enumeration date
07/09/2005
Last updated
08/14/2015
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