Provider Demographics
NPI:1912080144
Name:CUCCIA, DAVID J (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:J
Last Name:CUCCIA
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:80 GARDENIA DRIVE
Mailing Address - Street 2:SUITE B
Mailing Address - City:COVINGTON
Mailing Address - State:LA
Mailing Address - Zip Code:70433
Mailing Address - Country:US
Mailing Address - Phone:985-871-5900
Mailing Address - Fax:985-871-5911
Practice Address - Street 1:80 GARDENIA DRIVE
Practice Address - Street 2:SUITE B
Practice Address - City:COVINGTON
Practice Address - State:LA
Practice Address - Zip Code:70433
Practice Address - Country:US
Practice Address - Phone:985-871-5900
Practice Address - Fax:985-871-5911
Is Sole Proprietor?:No
Enumeration Date:2006-10-23
Last Update Date:2009-12-23
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Provider Licenses
StateLicense IDTaxonomies
MSMS19412207R00000X
LA024908207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS646000515EOtherBLUE CROSS OF MS
H62708Medicare UPIN