Healthcare Provider Details

I. General information

NPI: 1174519052
Provider Name (Legal Business Name): ERICA MENINA M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/26/2005
Last Update Date: 10/16/2024
Certification Date: 10/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1055 DAVID DR
MORGAN CITY LA
70380-1300
US

IV. Provider business mailing address

1055 DAVID DR
MORGAN CITY LA
70380-1300
US

V. Phone/Fax

Practice location:
  • Phone: 985-384-2430
  • Fax:
Mailing address:
  • Phone: 985-384-2430
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMD.026047
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: