Individual
DR. SEVETRI MOORE-GUILLAUME
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
8001 YOUREE DR, SUITE 880, SHREVEPORT, LA 71115-2302
(318) 212-3908
(318) 212-3909
Mailing address
8001 YOUREE DR, SUITE 880, SHREVEPORT, LA 71115-2302
(318) 212-3908
(318) 212-3909
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
016859
LA
207R00000X
Internal Medicine Physician
Primary
016859
LA
207R00000X
Internal Medicine Physician
31710
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1329517
—
LA
01
—
P00382860
RR MEDICARE
LA
Enumeration date
06/13/2006
Last updated
06/06/2025
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