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General NPI Number Information
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NPI Number | 1306903752
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Entity Type | Organization
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Legal Business Name | M. ANGELA MAYEUX, MD APMC
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Dates
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Enumeration Date | 01/03/2007
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Last Update Date | 06/18/2009
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Provider Practice Location Address
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Address Line | 1000 WEST PINHOOK RD STE 305
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City | LAFAYETTE
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State | LA
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Zip | 70503
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Country | US
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Telephone | 337-235-1600
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Fax | 337-235-1604
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Provider Business Mailing Address
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Address Line | 1000 WEST PINHOOK RD STE 305
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City | LAFAYETTE
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State | LA
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Zip | 70503
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Country | US
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Telephone | 337-235-1600
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Fax | 337-235-1604
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Authorized Official
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Title or Position | PRESIDENT
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Name | MARY ANGELA MAYEUX
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Credential | MD
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Telephone | 337-235-1600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 019577
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License Number State | LA
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