Individual
IVAN A. VILLALTA-WEHMEYER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
15790 PAUL VEGA MD, DR, HAMMOND, LA 70403
(985) 230-6900
(985) 230-6531
Mailing address
39359 BAY DR, PONCHATOULA, LA 70454-6657
(985) 230-6900
(985) 230-6531
Taxonomy
Speciality
Code
Description
License number
State
2080N0001X
Neonatal-Perinatal Medicine Physician
01032685A
IN
2080N0001X
Neonatal-Perinatal Medicine Physician
Primary
MD06771R
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1392995
—
LA
Enumeration date
11/06/2006
Last updated
05/22/2018
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