(800) 868-1923

Most Relevant Information


Provider Data
NPI Number: 1003558594
Provider Name: MATTHEW DISEDARE
Entity Type: Individual
Taxonomy Code: 171M00000X
Specialty: Case Manager/Care Coordinator
License Number:
Most Important Dates
Enumeration Date: 04/13/2022
Last Updated: 04/13/2022
Provider Practice Location
1418 TIGER DR
THIBODAUX
LA
703014337
Practice Location Phone/Fax
Phone: 9854494055
Fax: 9854494178
Provider Mailing Location
1418 TIGER DR
THIBODAUX
LA
703014337
Provider Mailing Phone/Fax
Phone: 9854494055
Fax: 9854494178