Edavettal, John Mathew

Edavettal, John Mathew is an individual health care provider with primary practice located at 441 Heymann Blvd , Lafayette LA 70503-2611. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Cardiovascular Disease, Allopathic & Osteopathic Physicians / Interventional Cardiology. Allopathic & Osteopathic Physicians / Interventional Cardiology is his primary health care specialty. Edavettal, John Mathew can be contacted via phone (337) 289-8429.

Contact Information

Primary practice address
441 Heymann Blvd Lafayette LA 70503-2611
Phone: (337) 289-8429
Fax: (337) 289-8431
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Cardiovascular Disease 207RC0000X 021589 Louisiana
Allopathic & Osteopathic Physicians / Interventional Cardiology 207RI0011X 021589 Louisiana

Profile Details

NPI number 1558333617
LBN Legal business name Edavettal, John Mathew
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 3rd, 2006
Last updated May 23rd, 2019 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1558333617 NPPES
Arkansas MEDICAID 205241001

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