Provider Demographics
NPI:1578630232
Name:LANDRENEAU, STEPHEN WAYNE (MD)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:WAYNE
Last Name:LANDRENEAU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1542 TULANE AVE
Mailing Address - Street 2:BOX T4-M2
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70112-2865
Mailing Address - Country:US
Mailing Address - Phone:504-568-4498
Mailing Address - Fax:504-568-2127
Practice Address - Street 1:1542 TULANE AVE
Practice Address - Street 2:BOX T4-M2
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70112-2865
Practice Address - Country:US
Practice Address - Phone:504-568-4498
Practice Address - Fax:504-568-2127
Is Sole Proprietor?:No
Enumeration Date:2006-11-29
Last Update Date:2016-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA204446207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology