Provider Demographics
NPI:1548200207
Name:MENUET, ROBERT L II (MD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:L
Last Name:MENUET
Suffix:II
Gender:M
Credentials:MD
Other - Prefix:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 4176
Mailing Address - Street 2:
Mailing Address - City:HOUMA
Mailing Address - State:LA
Mailing Address - Zip Code:70361-4176
Mailing Address - Country:US
Mailing Address - Phone:985-872-5864
Mailing Address - Fax:985-872-0317
Practice Address - Street 1:1233 WAYNE GILMORE CIR
Practice Address - Street 2:SUITE 450
Practice Address - City:OPELOUSAS
Practice Address - State:LA
Practice Address - Zip Code:70570-6405
Practice Address - Country:US
Practice Address - Phone:337-942-3006
Practice Address - Fax:337-942-7744
Is Sole Proprietor?:No
Enumeration Date:2006-06-08
Last Update Date:2009-09-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
LA15207R207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1058441Medicaid
LAP00364502Medicare PIN
LA4K169CF51Medicare PIN
LA4K1696833Medicare PIN
LA4K169Medicare PIN
LAI55500Medicare UPIN