MEDICARE: DR. CARLOS A SIRVEN MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207V00000X	Obstetrics & Gynecology Physician	016287	LA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1245206614
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CARLOS A SIRVEN MD

Provider Business Mailing Address
First Line	:	515 WESTBANK EXPY
Second Line	:	SUITE 7
City	:	GRETNA
State	:	LA
Zip	:	70053-5644
Country	:	US
Telephone Number	:	504-366-7233
Fax Number	:	504-366-0686

Provider Business Practice Location Address
First Line	:	515 WESTBANK EXPY
Second Line	:	SUITE 7
City	:	GRETNA
State	:	LA
Zip	:	70053-5644
Country	:	US
Telephone Number	:	504-366-7233
Fax Number	:	504-366-0686

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/27/2006
Last Update Date	:	11/27/2007

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Directions to “ DR. CARLOS A SIRVEN MD” Practice Location

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