Individual
DR. RICHARD JAMES MICHAEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1500 LINE AVE STE 204, SHREVEPORT, LA 71101-4648
(318) 300-4926
(318) 383-3951
Mailing address
1500 LINE AVE STE 204, SHREVEPORT, LA 71101-4648
(318) 300-4926
(318) 383-3951
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD.14448R
LA
208000000X
Pediatrics Physician
14448R
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1125865
—
LA
Enumeration date
06/09/2005
Last updated
01/14/2019
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