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NPI Code Detail

MEDICARE: SIDNEY H RAYMOND MD

MEDICARE: SIDNEY H RAYMOND MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine Physician023838LA

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
25E907DH01OTHERLAMEDICARE PTAN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1629041777
Entity Type Code : Individual
Provider Name (Legal Business Name) : SIDNEY H RAYMOND MD
Provider Business Mailing Address
First Line : 1514 JEFFERSON HWY
Second Line :
City : NEW ORLEANS
State : LA
Zip : 70121-2429
Country : US
Telephone Number : 504-842-4000
Fax Number :
Provider Business Practice Location Address
First Line : 13100 RIVER RD
Second Line : SUITE 120
City : DESTREHAN
State : LA
Zip : 70047-5219
Country : US
Telephone Number : 985-764-7669
Fax Number : 985-764-7234
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/09/2006
Last Update Date : 04/25/2017

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Directions to “ SIDNEY H RAYMOND MD” Practice Location

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