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General NPI Number Information
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NPI Number | 1710903059
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Entity Type | Organization
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Legal Business Name | C & M MEDICAL SERVICES, INC.
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Dates
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Enumeration Date | 07/13/2006
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Last Update Date | 03/22/2022
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Provider Practice Location Address
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Address Line | 2450 SEVERN AVE STE 205
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City | METAIRIE
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State | LA
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Zip | 70001
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Country | US
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Telephone | 504-833-7770
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Fax | 504-833-7782
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Provider Business Mailing Address
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Address Line | 2450 SEVERN AVE STE 205
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City | METAIRIE
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State | LA
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Zip | 70001-1931
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Country | US
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Telephone | 504-833-7770
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Fax | 504-833-7782
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Authorized Official
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Title or Position | AM
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Name | AMY D. PROVOST
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Credential |
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Telephone | 337-534-0952
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207PE0004X
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Taxonomy Name | Emergency Medical Services (Emergency Medicine) Physician
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License Number |
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License Number State | LA
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