Provider Demographics
NPI:1275748675
Name:CEASAR, SHANNON CHRISTOPHER (MD)
Entity Type:Individual
Prefix:DR
First Name:SHANNON
Middle Name:CHRISTOPHER
Last Name:CEASAR
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 1:3801 HOUMA BLVD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70006-4165
Mailing Address - Country:US
Mailing Address - Phone:504-309-8135
Mailing Address - Fax:504-309-8156
Practice Address - Street 1:3801 HOUMA BLVD
Practice Address - Street 2:SUITE 100
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70006-4165
Practice Address - Country:US
Practice Address - Phone:504-309-8135
Practice Address - Fax:504-309-8156
Is Sole Proprietor?:No
Enumeration Date:2007-05-11
Last Update Date:2016-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA025275208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA4A360DU06Medicare UPIN