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Organization

DEIDRE L STELLY MD APMLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. DEIDRE L STELLY MD (OWNER)
(337) 261-5151
Entity
Organization

Contact information

Practice address
112 CHAMPAGNE BLVD, BREAUX BRIDGE, LA 70517-3852
(337) 261-5151
Mailing address
112 CHAMPAGNE BLVD, BREAUX BRIDGE, LA 70517-3852
(337) 332-2242

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1443077
LA
Enumeration date
10/06/2005
Last updated
03/10/2008
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