Provider Demographics
NPI:1770791212
Name:VIATOR, ANDRE STEPHEN (MD)
Entity type:Individual
Prefix:DR
First Name:ANDRE
Middle Name:STEPHEN
Last Name:VIATOR
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Gender:F
Credentials:MD
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Mailing Address - Street 1:PO BOX 69300
Mailing Address - Street 2:QM
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70596-9300
Mailing Address - Country:US
Mailing Address - Phone:337-261-6690
Mailing Address - Fax:337-261-6662
Practice Address - Street 1:2390 W CONGRESS ST
Practice Address - Street 2:QM
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70506-4205
Practice Address - Country:US
Practice Address - Phone:337-261-6690
Practice Address - Fax:337-261-6662
Is Sole Proprietor?:No
Enumeration Date:2007-05-18
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
LAPGY.2-LSULAF207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine