Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | MD.202966 | LA |
Y | 208600000X | Surgeon | MD.202966 | LA |
N | 2082S0105X | Plastic Hand Surgeon | MD.202966 | LA |
NPI | 1063679512 |
---|---|
Provider Name | Mary C Ghere |
First Address | Baton Rouge, LA 70808-4263 |
Second Address | Baton Rouge, LA 70808 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/05/2008 |
Last Update Date | 21/08/2018 |