Provider Demographics
NPI:1932409646
Name:MAUTERER SURGICAL LLC.
Entity Type:Organization
Organization Name:MAUTERER SURGICAL LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CSFA
Authorized Official - Prefix:MR
Authorized Official - First Name:JEROME
Authorized Official - Middle Name:CHARLES
Authorized Official - Last Name:MAUTERER
Authorized Official - Suffix:SR
Authorized Official - Credentials:
Authorized Official - Phone:985-445-6902
Mailing Address - Street 1:1902 WELLINGTON LN
Mailing Address - Street 2:
Mailing Address - City:SLIDELL
Mailing Address - State:LA
Mailing Address - Zip Code:70461-4812
Mailing Address - Country:US
Mailing Address - Phone:985-445-6902
Mailing Address - Fax:985-781-4872
Practice Address - Street 1:1902 WELLINGTON LN
Practice Address - Street 2:
Practice Address - City:SLIDELL
Practice Address - State:LA
Practice Address - Zip Code:70461-4812
Practice Address - Country:US
Practice Address - Phone:985-445-6902
Practice Address - Fax:985-781-4872
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-27
Last Update Date:2010-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246ZS0410XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical TechnologistGroup - Single Specialty