Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RN0300X | Nephrologist | 03956R | LA |
NPI | 1003852567 |
---|---|
Provider Name | Dr. Maximo Bienvenido Lamarche |
First Address | Lafayette, LA 70506-4638 |
Second Address | Lafayette, LA 70506-4638 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/06/2006 |
Last Update Date | 10/11/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1193216 | (05) | LA |
B60799 | (02) | LA |