Individual
ROSS MICHAEL DIES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2021 PERDIDO ST RM 5128, NEW ORLEANS, LA 70112-1352
(504) 568-5600
Mailing address
9635 LOCKHEED DR, SHREVEPORT, LA 71106-3426
(318) 562-0236
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2662651
—
LA
Enumeration date
03/19/2024
Last updated
07/26/2024
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