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Contact Information

EDWARD W DAUTERIVE JR, MD
1100 ANDRE ST
NEW IBERIA, LA70563-2159
 Phone: 337-369-9309
 Fax: 337-365-8455
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Vascular Surgery

2086S0129X 76 Physician/Peripheral Vascular Disease
 

Surgery

208600000X 02 Physician/General Surgery
Indicates primary specialty

NPI Profile & details for EDWARD W DAUTERIVE JR · (Male)

NPI # 1538151451
Status Active
Credentials MD
Entity Individual
Enumeration date 08/17/2005
Last updated 06/27/2008 - About 18 years ago
Sole proprietor 1 No
Identifiers
  • LA License # 014729
  • LA Medicaid 1339334
Hospital affiliation(s)
  • IBERIA GENERAL HOSPITAL AND MEDICAL CENTER - (Acute Care)
    2315 E MAIN STREET
    NEW IBERIA, LA 70562
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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