MEDICARE: MICHAEL A. TRAUB, M.D., APMC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QP2300X	Primary Care Clinic/Center	014217	LA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1164669206
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MICHAEL A. TRAUB, M.D., APMC

Provider Business Mailing Address
First Line	:	711 DR MICHAEL DEBAKEY DR
Second Line	:	SUITE 200
City	:	LAKE CHARLES
State	:	LA
Zip	:	70601-5785
Country	:	US
Telephone Number	:	337-436-6100
Fax Number	:	337-439-4484

Provider Business Practice Location Address
First Line	:	711 DR MICHAEL DEBAKEY DR
Second Line	:	SUITE 200
City	:	LAKE CHARLES
State	:	LA
Zip	:	70601-5785
Country	:	US
Telephone Number	:	337-436-6100
Fax Number	:	337-439-4484

Authorized Official
Title or Position	:	CEO
Name	:	DR. MICHAEL ANTHONY TRAUB
Credential	:	M.D.
Telephone Number	:	13374366100

Provider Enumeration Date	:	01/12/2009
Last Update Date	:	01/13/2009

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