Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | MD.04082R | LA |
NPI | 1033187273 |
---|---|
Provider Name | Errol J Quintal SR. |
First Address | New Orleans, LA 70121 |
Second Address | Baton Rouge, LA 70809-3726 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/03/2006 |
Last Update Date | 04/01/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00486368 | (05) | MS |
1125814 | (05) | LA |
B89713 | (02) | LA |