Healthcare Provider Details

I. General information

NPI: 1962792291
Provider Name (Legal Business Name): MATTHEW DAVID ZELHART M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/07/2011
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3100 GALLERIA DR STE 303
METAIRIE LA
70001-2196
US

IV. Provider business mailing address

3100 GALLERIA DR STE 303
METAIRIE LA
70001-2196
US

V. Phone/Fax

Practice location:
  • Phone: 504-456-5108
  • Fax: 504-456-5109
Mailing address:
  • Phone: 504-456-5108
  • Fax: 504-456-5109

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208C00000X
TaxonomyColon & Rectal Surgery Physician
License Number207947
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: