Provider Demographics
NPI:1003954439
Name:DUPONT, MARIA ZHEANETTE (BS,RT(R)(M))
Entity Type:Individual
Prefix:MISS
First Name:MARIA
Middle Name:ZHEANETTE
Last Name:DUPONT
Suffix:
Gender:F
Credentials:BS,RT(R)(M)
Other - Prefix:MR
Other - First Name:CRAIG
Other - Middle Name:
Other - Last Name:DUPLECHIN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:306 N MCGOWN ST
Mailing Address - Street 2:
Mailing Address - City:RAYNE
Mailing Address - State:LA
Mailing Address - Zip Code:70578-7045
Mailing Address - Country:US
Mailing Address - Phone:337-231-0099
Mailing Address - Fax:337-237-0062
Practice Address - Street 1:1021 COOLIDGE BLVD
Practice Address - Street 2:SUITE 200
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70503-2435
Practice Address - Country:US
Practice Address - Phone:337-231-0099
Practice Address - Fax:337-237-0062
Is Sole Proprietor?:No
Enumeration Date:2007-02-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA57242471C3402X, 2471M2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered2471C3402XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistRadiography
Not Answered2471M2300XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistMammography