Individual
ROGER EDMUND STUEBEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1107 AUDUBON AVE, SUITE B, THIBODAUX, LA 70301
(985) 447-5864
(985) 447-5851
Mailing address
1107 AUDUBON AVE, SUITE B, THIBODAUX, LA 70301
(985) 447-5864
(985) 447-5851
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
013386
LA
207RS0012X
Sleep Medicine (Internal Medicine) Physician
013386
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1180637
—
LA
Enumeration date
12/13/2006
Last updated
05/22/2012
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