Individual
DR. MICHAEL GERARD D'ANTONIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1111 MEDICAL CENTER BLVD, STE. N-108, MARRERO, LA 70072-3151
(504) 349-1461
(504) 349-1461
Mailing address
PO BOX 1339, MARRERO, LA 70073-1339
(504) 349-1461
(504) 349-1461
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
020573
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
05054550
—
MS
05
—
1681521
—
LA
Enumeration date
05/08/2006
Last updated
01/17/2011
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