Provider Demographics
NPI:1285631085
Name:SAVANT, SHELLY NICOLE (MD)
Entity Type:Individual
Prefix:DR
First Name:SHELLY
Middle Name:NICOLE
Last Name:SAVANT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1100 ANDRE STREET
Mailing Address - Street 2:SUITE 302
Mailing Address - City:NEW IBERIA
Mailing Address - State:LA
Mailing Address - Zip Code:70563
Mailing Address - Country:US
Mailing Address - Phone:337-365-6797
Mailing Address - Fax:337-560-4517
Practice Address - Street 1:1100 ANDRE STREET
Practice Address - Street 2:SUITE 302
Practice Address - City:NEW IBERIA
Practice Address - State:LA
Practice Address - Zip Code:70563
Practice Address - Country:US
Practice Address - Phone:337-365-6797
Practice Address - Fax:337-560-4517
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-07
Last Update Date:2012-12-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
LA0255642084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology