Provider Demographics
NPI:1275691248
Name:MOREL, CHRISTIAN EDWARD
Entity Type:Individual
Prefix:DR
First Name:CHRISTIAN
Middle Name:EDWARD
Last Name:MOREL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8230 SUMMA AVE STE C
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70809-3465
Mailing Address - Country:US
Mailing Address - Phone:225-757-0552
Mailing Address - Fax:225-763-9997
Practice Address - Street 1:5000 HENNESSY BLVD
Practice Address - Street 2:OUR LADY OF THE LAKE RMC RADIOLOGY DEPT.
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70808-4375
Practice Address - Country:US
Practice Address - Phone:225-757-0552
Practice Address - Fax:225-763-9997
Is Sole Proprietor?:No
Enumeration Date:2006-12-04
Last Update Date:2014-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA0260232085R0202X, 2085N0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
No2085N0700XAllopathic & Osteopathic PhysiciansRadiologyNeuroradiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1055891Medicaid
LAP00637235OtherMEDICARE RAILROAD
LA4N195OtherMEDICARE