Provider Demographics
NPI:1477551307
Name:BESCH, CERYL LYNN (MD)
Entity Type:Individual
Prefix:DR
First Name:CERYL
Middle Name:LYNN
Last Name:BESCH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1340 POYDRAS ST
Mailing Address - Street 2:SUITE 1640
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70112-1221
Mailing Address - Country:US
Mailing Address - Phone:504-412-1860
Mailing Address - Fax:
Practice Address - Street 1:136 S ROMAN ST
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70112-3095
Practice Address - Country:US
Practice Address - Phone:504-903-0907
Practice Address - Fax:504-903-5313
Is Sole Proprietor?:No
Enumeration Date:2005-07-13
Last Update Date:2008-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA015114207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1307106Medicaid
5M5607054Medicare UPIN
B61887Medicare UPIN
LA5M560Medicare PIN
LA5M560F669Medicare PIN