Provider Demographics
NPI:1336405935
Name:METOYER, CHEYNITA (MD)
Entity type:Individual
Prefix:
First Name:CHEYNITA
Middle Name:
Last Name:METOYER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5751 SHED RD STE 120
Mailing Address - Street 2:
Mailing Address - City:BOSSIER CITY
Mailing Address - State:LA
Mailing Address - Zip Code:71111-5662
Mailing Address - Country:US
Mailing Address - Phone:318-935-1922
Mailing Address - Fax:318-935-1925
Practice Address - Street 1:5751 SHED RD STE 120
Practice Address - Street 2:
Practice Address - City:BOSSIER CITY
Practice Address - State:LA
Practice Address - Zip Code:71111-5662
Practice Address - Country:US
Practice Address - Phone:318-935-1922
Practice Address - Fax:318-935-1925
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-09
Last Update Date:2024-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA302400207R00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA218810Medicaid