MEDICARE: DR. SHWETA SIDHU

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	2084P0804X	Child & Adolescent Psychiatry Physician	311040	LA
2	390200000X	Student in an Organized Health Care Education/Training Program		NC
3	2084P0800X	Psychiatry Physician	311040	LA

General Provider Information

NPI Number	:	1346673332
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SHWETA SIDHU

Provider Business Mailing Address
First Line	:	5131 ODONOVAN DR STE 300
Second Line	:
City	:	BATON ROUGE
State	:	LA
Zip	:	70808-4792
Country	:	US
Telephone Number	:	225-374-0400
Fax Number	:

Provider Business Practice Location Address
First Line	:	5131 ODONOVAN DR STE 300
Second Line	:
City	:	BATON ROUGE
State	:	LA
Zip	:	70808-4792
Country	:	US
Telephone Number	:	225-374-0400
Fax Number	:

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

Provider Enumeration Date	:	08/14/2013
Last Update Date	:	04/09/2021

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Directions to “ DR. SHWETA SIDHU ” Practice Location

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