Provider Demographics
NPI:1598101008
Name:DEVILLE, SYDNEY ELIZABETH (MD)
Entity Type:Individual
Prefix:DR
First Name:SYDNEY
Middle Name:ELIZABETH
Last Name:DEVILLE
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:PO BOX 13038
Mailing Address - Street 2:APT 2A
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70185-3038
Mailing Address - Country:US
Mailing Address - Phone:504-212-9538
Mailing Address - Fax:504-212-9524
Practice Address - Street 1:127 CARONDELET ST
Practice Address - Street 2:APT 2A
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70130-2514
Practice Address - Country:US
Practice Address - Phone:504-564-3348
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-05-13
Last Update Date:2016-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA301692208000000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program