Provider Demographics
NPI:1144350505
Name:DEVILLIER, MARNE' EVE (MD)
Entity type:Individual
Prefix:DR
First Name:MARNE'
Middle Name:EVE
Last Name:DEVILLIER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3702 MAPLEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:SULPHUR
Mailing Address - State:LA
Mailing Address - Zip Code:70663-6302
Mailing Address - Country:US
Mailing Address - Phone:337-625-5459
Mailing Address - Fax:337-626-2045
Practice Address - Street 1:3702 MAPLEWOOD DR
Practice Address - Street 2:
Practice Address - City:SULPHUR
Practice Address - State:LA
Practice Address - Zip Code:70663-6302
Practice Address - Country:US
Practice Address - Phone:337-625-5459
Practice Address - Fax:337-626-2045
Is Sole Proprietor?:No
Enumeration Date:2007-03-06
Last Update Date:2008-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAMD.200282207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA4K872BD22Medicare PIN
LA5BD22Medicare PIN