Provider Demographics
NPI:1023307329
Name:VERLANDER, GREGORY ELMORE (MD)
Entity type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:ELMORE
Last Name:VERLANDER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:610 GIRARD PARK DR
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70503-2804
Mailing Address - Country:US
Mailing Address - Phone:337-233-4463
Mailing Address - Fax:
Practice Address - Street 1:610 GIRARD PARK DR
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70503-2804
Practice Address - Country:US
Practice Address - Phone:337-233-4463
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-04-07
Last Update Date:2017-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAMD.207669207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology