Individual
DR. MARCELO GRANADO POLANCO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
731 S MAIN ST STE A, CHURCH POINT, LA 70525
(337) 684-0911
(337) 684-0912
Mailing address
731 S MAIN ST STE A, CHURCH POINT, LA 70525
(337) 684-0911
(337) 684-0912
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
023828
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1485438
—
LA
Enumeration date
10/26/2006
Last updated
06/07/2011
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