Healthcare Provider Details

I. General information

NPI: 1265527469
Provider Name (Legal Business Name): RICHARD OBERHELMAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/04/2006
Last Update Date: 02/24/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1415 TULANE AVE
NEW ORLEANS LA
70112-2600
US

IV. Provider business mailing address

1430 TULANE AVE TW22
NEW ORLEANS LA
70112-2632
US

V. Phone/Fax

Practice location:
  • Phone: 504-988-2300
  • Fax: 504-988-7654
Mailing address:
  • Phone: 504-988-2300
  • Fax: 504-988-7654

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0208X
TaxonomyPediatric Infectious Diseases Physician
License Number06420R
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: