Provider Demographics
NPI:1255314969
Name:HINES, MICHAEL HERBERT (MD)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:HERBERT
Last Name:HINES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1514 JEFFERSON HWY
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70121-2429
Mailing Address - Country:US
Mailing Address - Phone:504-842-4000
Mailing Address - Fax:
Practice Address - Street 1:1514 JEFFERSON HWY
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70121-2429
Practice Address - Country:US
Practice Address - Phone:504-842-4070
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-11-28
Last Update Date:2017-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN9224208G00000X
NC31835208G00000X
LA307445208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC11336OtherPARTNERS
5252574OtherAETNA
NC8942513Medicaid
NC25412OtherMEDCOST
NC42513OtherBCBS
VA7304099Medicaid
SCQ31835Medicaid
WV216937000Medicaid
TX8CU973OtherBCBS
NC207286EMedicare PIN
SCQ31835Medicaid
NC42513OtherBCBS