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Individual

GUILLERMO PABLO SANGSTER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1501 KINGS HWY, DEPARTMENT OF RADIOLOGY, SHREVEPORT, LA 71103-4228
(318) 675-7636
(318) 675-5666
Mailing address
1512 W KIRBY PL, SHREVEPORT, LA 71103-3822
(318) 675-7636
(318) 675-5666

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
14877R
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1153800
LA
01
4F547F600
MEDICARE - PTAN
LA
Enumeration date
07/15/2006
Last updated
08/02/2011
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