Degravelle, Martin Joseph

Degravelle, Martin Joseph is an individual health care provider with primary practice located at 2308 E Main St , New Iberia LA 70560-4032. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Degravelle, Martin Joseph can be contacted via phone (337) 560-5005.

Contact Information

Primary practice address
2308 E Main St New Iberia LA 70560-4032
Phone: (337) 560-5005
Fax: (337) 560-9757
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X MD011998 Louisiana

Profile Details

NPI number 1700826500
LBN Legal business name Degravelle, Martin Joseph
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 8th, 2006
Last updated Jul 8th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1700826500 NPPES
Louisiana MEDICAID 1147303
Louisiana Other 5052399

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