Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0100X | Gastroenterologist | 019105 | LA |
NPI | 1043288160 |
---|---|
Provider Name | Charles J Monier JR. |
First Address | Thibodaux, LA 70301-5009 |
Second Address | Thibodaux, LA 70301-4847 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/03/2006 |
Last Update Date | 12/05/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1386171 | (05) | LA |
D87056 | (02) | LA |