Provider Demographics
NPI:1457491375
Name:SANDS, MARK A (MD)
Entity Type:Individual
Prefix:
First Name:MARK
Middle Name:A
Last Name:SANDS
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 1:4721 CARTHAGE ST
Mailing Address - Street 2:
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70002-1410
Mailing Address - Country:US
Mailing Address - Phone:504-838-8283
Mailing Address - Fax:
Practice Address - Street 1:110 VETERANS MEMORIAL BLVD
Practice Address - Street 2:SUITE 425
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70005-3027
Practice Address - Country:US
Practice Address - Phone:504-838-8283
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-08
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA07835R2084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA07835ROtherMEDICAL LICENSE
LABS3676193OtherDEA
LABS3676193OtherDEA