Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2084N0400X | Neurologist | MD020562 | LA |
NPI | 1023082856 |
---|---|
Provider Name | Michael P Charlet |
First Address | Houma, LA 70361-1094 |
Second Address | Houma, LA 70360-4412 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/02/2006 |
Last Update Date | 26/07/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1963003 | (05) | LA |
F52297 | (02) | LA |