MEDICARE: HAROLD G BIENVENU III M.D.

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	207YX0905X	Otolaryngology/Facial Plastic Surgery Physician	MD.015116	LA

General Provider Information

NPI Number	:	1497709307
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HAROLD G BIENVENU III M.D.

Provider Business Mailing Address
First Line	:	426 CHARLES ST
Second Line	:
City	:	NEW IBERIA
State	:	LA
Zip	:	70560-3876
Country	:	US
Telephone Number	:	337-365-4156
Fax Number	:	337-365-4095

Provider Business Practice Location Address
First Line	:	426 CHARLES ST
Second Line	:
City	:	NEW IBERIA
State	:	LA
Zip	:	70560-3876
Country	:	US
Telephone Number	:	337-365-4156
Fax Number	:	337-365-4095

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/22/2006
Last Update Date	:	05/25/2021

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