Healthcare Provider Details

I. General information

NPI: 1912114554
Provider Name (Legal Business Name): STACEY ANN SCHEIB MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/16/2007
Last Update Date: 04/14/2025
Certification Date: 04/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4770 S I 10 SERVICE RD W STE 201
METAIRIE LA
70001-1265
US

IV. Provider business mailing address

4770 S I 10 SERVICE RD W STE 201
METAIRIE LA
70001-1265
US

V. Phone/Fax

Practice location:
  • Phone: 504-454-2165
  • Fax: 504-888-2250
Mailing address:
  • Phone: 504-454-2165
  • Fax: 504-888-2250

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License Number43773
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberMT184096
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License NumberD0074401
License Number StateMD
# 4
Primary TaxonomyY
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License Number306870
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: