Mabry, Dwan Shirmelle

Mabry, Dwan Shirmelle is an sole proprietor health care provider with primary practice located at 15748 Medical Arts Dr , Hammond LA 70403-1446. She recently has only one registered license in Allopathic & Osteopathic Physicians / Gynecology, which is considered as her primary health care specialty. Mabry, Dwan Shirmelle can be contacted via phone (985) 542-0663.

Contact Information

Primary practice address
15748 Medical Arts Dr Hammond LA 70403-1446
Fax: (985) 542-7010
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Gynecology 207VG0400X MD.022096 Louisiana

Profile Details

NPI number 1104822782
LBN Legal business name Mabry, Dwan Shirmelle
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 28th, 2005
Last updated Sep 19th, 2013 - about 13 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 1104822782 NPPES
Louisiana MEDICAID 1491853

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