Provider Demographics
NPI:1275988719
Name:DARCE, MATTHEW MICHAEL
Entity Type:Individual
Prefix:MR
First Name:MATTHEW
Middle Name:MICHAEL
Last Name:DARCE
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 1:274 EVANGELINE DR
Mailing Address - Street 2:
Mailing Address - City:MANDEVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:70471-1882
Mailing Address - Country:US
Mailing Address - Phone:985-789-0449
Mailing Address - Fax:
Practice Address - Street 1:5246 BRITTANY DRIVE
Practice Address - Street 2:LSU INTERNAL MEDICINE RESIDENCY BATON ROUGE
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70808
Practice Address - Country:US
Practice Address - Phone:225-757-4070
Practice Address - Fax:225-757-4100
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-03
Last Update Date:2023-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY309340-012085R0202X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program