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General NPI Number Information
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NPI Number | 1275748675
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Entity Type | Individual
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Provider Name | SHANNON CHRISTOPHER CEASAR M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/11/2007
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Last Update Date | 03/07/2016
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Provider Practice Location Address
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Address Line | 3801 HOUMA BLVD SUITE 100
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City | METAIRIE
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State | LA
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Zip | 70006-4165
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Country | US
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Telephone | 504-309-8135
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Fax | 504-309-8156
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Provider Business Mailing Address
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Address Line | 3801 HOUMA BLVD SUITE 100
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City | METAIRIE
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State | LA
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Zip | 70006-4165
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Country | US
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Telephone | 504-309-8135
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Fax | 504-309-8156
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 025275
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License Number State | LA
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