Provider Demographics
NPI:1023082856
Name:CHARLET, MICHAEL P (MD)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:P
Last Name:CHARLET
Suffix:
Gender:M
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:PO BOX 1094
Mailing Address - Street 2:
Mailing Address - City:HOUMA
Mailing Address - State:LA
Mailing Address - Zip Code:70361-1094
Mailing Address - Country:US
Mailing Address - Phone:985-223-3132
Mailing Address - Fax:982-223-3126
Practice Address - Street 1:1022 BELANGER ST
Practice Address - Street 2:
Practice Address - City:HOUMA
Practice Address - State:LA
Practice Address - Zip Code:70360-4412
Practice Address - Country:US
Practice Address - Phone:985-223-3132
Practice Address - Fax:982-223-3126
Is Sole Proprietor?:No
Enumeration Date:2006-02-16
Last Update Date:2017-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAMD0205622084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1963003Medicaid
LAF52297Medicare UPIN
LA1963003Medicaid
LA5R583Medicare PIN