Healthcare Provider Details

I. General information

NPI: 1346508256
Provider Name (Legal Business Name): MELISSA ANN SPERA M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/27/2012
Last Update Date: 07/03/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1542 TULANE AVE
NEW ORLEANS LA
70112
US

IV. Provider business mailing address

1542 TULANE AVE # T4M2
NEW ORLEANS LA
70112-2865
US

V. Phone/Fax

Practice location:
  • Phone: 504-538-5477
  • Fax:
Mailing address:
  • Phone: 504-538-5477
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD.207843
License Number StateLA
# 3
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License NumberMD.207843
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: