Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | 021622 | LA |
NPI | 1013917533 |
---|---|
Provider Name | Monique Michelle Monteilh |
First Address | Lafayette, LA 70508-6902 |
Second Address | Lafayette, LA 70508-6902 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/07/2005 |
Last Update Date | 24/09/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1996734 | (05) | LA |
F94465 | (02) |