Provider Demographics
NPI:1659434330
Name:ANDRESSEN, HENRY W (MD)
Entity Type:Individual
Prefix:DR
First Name:HENRY
Middle Name:W
Last Name:ANDRESSEN
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 1:4720 S I-10 SERVICE ROAD
Mailing Address - Street 2:SUITE 104
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70001
Mailing Address - Country:US
Mailing Address - Phone:504-457-0299
Mailing Address - Fax:504-457-0296
Practice Address - Street 1:4720 S I-10 SERVICE ROAD
Practice Address - Street 2:SUITE 104
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70001
Practice Address - Country:US
Practice Address - Phone:504-457-0299
Practice Address - Fax:504-457-0296
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA008317207VX0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1095664Medicaid
LA1095664Medicaid