MEDICARE: DR. DAMON T CUDIHY MD

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	207V00000X	Obstetrics & Gynecology Physician	MD436149	PA
2	207V00000X	Obstetrics & Gynecology Physician	055817	GA
3	207V00000X	Obstetrics & Gynecology Physician	MD206213	LA

General Provider Information

NPI Number	:	1720078520
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAMON T CUDIHY MD

Provider Business Mailing Address
First Line	:	155 HOSPITAL DR
Second Line	:	SUITE 302
City	:	LAFAYETTE
State	:	LA
Zip	:	70503-2636
Country	:	US
Telephone Number	:	337-261-5433
Fax Number	:	337-269-9652

Provider Business Practice Location Address
First Line	:	1211 COOLIDGE BLVD
Second Line	:	SUITE 403
City	:	LAFAYETTE
State	:	LA
Zip	:	70503-2636
Country	:	US
Telephone Number	:	337-261-5433
Fax Number	:	337-269-9652

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

Provider Enumeration Date	:	10/24/2005
Last Update Date	:	07/18/2017

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