Individual
THADDEUS RAY ERATO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1052 LAKESHORE BLVD, SLIDELL, LA 70461-4678
(504) 339-3472
Mailing address
1052 LAKESHORE BLVD, SLIDELL, LA 70461-4678
(504) 339-3472
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
10535R
LA
207P00000X
Emergency Medicine Physician
Primary
MD.10535R
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04609769
—
MS
05
—
1675211
—
LA
Enumeration date
07/16/2006
Last updated
11/22/2013
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