Provider Demographics
NPI:1467803585
Name:SHOENFELT, ABIGAIL MARIE (MD)
Entity Type:Individual
Prefix:MRS
First Name:ABIGAIL
Middle Name:MARIE
Last Name:SHOENFELT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MS
Other - First Name:ABIGAIL
Other - Middle Name:MARIE
Other - Last Name:FREEMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:342 E WOODGATE CT
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70808-5409
Mailing Address - Country:US
Mailing Address - Phone:225-252-3565
Mailing Address - Fax:225-765-9196
Practice Address - Street 1:8416 CUMBERLAND PL
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70806-6543
Practice Address - Country:US
Practice Address - Phone:225-252-3565
Practice Address - Fax:985-781-4319
Is Sole Proprietor?:No
Enumeration Date:2016-06-30
Last Update Date:2023-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAMD-45386208D00000X
390200000X
LA3069042084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA302542OtherLSBME PERMIT
LA2423541Medicaid