Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RC0000X | Internist - Cardiovascular Disease | 15289R | LA |
Y | 207RI0011X | Interventional Cardiology | 15289R | LA |
NPI | 1013914050 |
---|---|
Provider Name | Salvatore Buttaci-Guarino |
First Address | Covington, LA 70433-7506 |
Second Address | Covington, LA 70433-7506 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/07/2005 |
Last Update Date | 19/02/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1169633 | (05) | LA |
H96336 | (02) | LA |
P00057074 | RR MEDICARE (01) | LA |