Healthcare Provider Details

I. General information

NPI: 1821019217
Provider Name (Legal Business Name): SHELDON M HERSH MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/21/2006
Last Update Date: 07/25/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1301 SIMON BOLIVAR AVE
NEW ORLEANS LA
70113-2222
US

IV. Provider business mailing address

506 SHORT ST
NEW ORLEANS LA
70118-2723
US

V. Phone/Fax

Practice location:
  • Phone: 504-723-5099
  • Fax: 504-617-6505
Mailing address:
  • Phone: 504-723-5099
  • Fax: 504-617-6505

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0300X
TaxonomyGeriatric Medicine (Internal Medicine) Physician
License Number013429
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: