Healthcare Provider Details

I. General information

NPI: 1609005073
Provider Name (Legal Business Name): INNOVATIVE HOSPITALIST SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/07/2009
Last Update Date: 07/07/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

85 WHISPERWOOD BLVD STE 1S
SLIDELL LA
70458-1136
US

IV. Provider business mailing address

85 WHISPERWOOD BLVD STE 1S
SLIDELL LA
70458-1136
US

V. Phone/Fax

Practice location:
  • Phone: 985-781-8565
  • Fax: 985-781-5395
Mailing address:
  • Phone: 985-781-8565
  • Fax: 985-781-5395

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. AMY SHEEDER
Title or Position: MEMBER
Credential: M.D.
Phone: 985-781-8565