Organization
MG DESALVO MD&GM GREMILLION MDAMC
Active
Other names
Michael G. DeSalvo, MD, A Med. Corp
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CYNTHIA M. PETTA (OFFICE MANAGE)
(504) 885-4677
Entity
Organization
Contact information
Practice address
3645 HOUMA BLVD, METAIRIE, LA 70006-4229
(504) 885-4677
(504) 888-0549
Mailing address
3645 HOUMA BLVD, METAIRIE, LA 70006-4229
(504) 885-4677
(504) 888-0549
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
207Y00000X
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1149179
—
LA
Enumeration date
03/30/2007
Last updated
12/31/2020
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