Provider Demographics
NPI:1437177821
Name:HEMELT, TERRELL MICHAEL (MD)
Entity Type:Individual
Prefix:DR
First Name:TERRELL
Middle Name:MICHAEL
Last Name:HEMELT
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 1:2243 GAUSE BLVD E
Mailing Address - Street 2:
Mailing Address - City:SLIDELL
Mailing Address - State:LA
Mailing Address - Zip Code:70461-4232
Mailing Address - Country:US
Mailing Address - Phone:985-643-6355
Mailing Address - Fax:985-643-0130
Practice Address - Street 1:2243 GAUSE BLVD E
Practice Address - Street 2:
Practice Address - City:SLIDELL
Practice Address - State:LA
Practice Address - Zip Code:70461-4232
Practice Address - Country:US
Practice Address - Phone:985-643-6355
Practice Address - Fax:985-643-0130
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2012-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAL023111207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
LAG59176Medicare UPIN
LA5Y848Medicare PIN