Healthcare Provider Details

I. General information

NPI: 1467440891
Provider Name (Legal Business Name): VICTORIA E PANELLI-RAMERY MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/10/2005
Last Update Date: 03/13/2020
Certification Date: 03/13/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1211 COOLIDGE BLVD SUITE100
LAFAYETTE LA
70503-2636
US

IV. Provider business mailing address

1211 COOLIDGE BLVD SUITE B
LAFAYETTE LA
70503-2636
US

V. Phone/Fax

Practice location:
  • Phone: 337-289-8400
  • Fax: 337-289-8401
Mailing address:
  • Phone: 337-289-8400
  • Fax: 337-289-8401

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number24025
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number24025
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: