Individual
DR. BRYAN BERTUCCI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
843 MILLING AVE, LULING, LA 70070-4442
(985) 785-5851
(504) 278-4692
Mailing address
7718 W JUDGE PEREZ DR, ARABI, LA 70032-1919
(504) 271-8952
(504) 278-4692
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
015628
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
015628
LA. LICENSE
LA
05
—
1328031
—
LA
05
—
1444642
—
LA
05
—
2137689
—
LA
Enumeration date
08/21/2006
Last updated
03/18/2011
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