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General NPI Number Information
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NPI Number | 1316732597
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Entity Type | Individual
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Provider Name | MICHAEL HEBERT
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Gender | Male
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Dates
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Enumeration Date | 04/10/2025
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Last Update Date | 04/10/2025
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Provider Practice Location Address
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Address Line | 330 BROOKLINE AVE, SHAPIRO 807
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City | BOSTON
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State | MA
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Zip | 02215
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Country | US
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Telephone | 781-744-5554
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Fax |
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Provider Business Mailing Address
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Address Line | 4600 SHERYL LN
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City | LAKE CHARLES
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State | LA
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Zip | 70605-5179
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Country | US
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Telephone | 337-515-6755
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Fax |
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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 | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | 3018612
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License Number State | MA
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