Provider Demographics
NPI:1780823765
Name:THE SPECIALIST GROUP
Entity Type:Organization
Organization Name:THE SPECIALIST GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MARIUS
Authorized Official - Middle Name:
Authorized Official - Last Name:SHARON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:985-764-1441
Mailing Address - Street 1:1972 ORMOND BLVD
Mailing Address - Street 2:SUITE B
Mailing Address - City:DESTREHAN
Mailing Address - State:LA
Mailing Address - Zip Code:70047-3818
Mailing Address - Country:US
Mailing Address - Phone:985-764-1441
Mailing Address - Fax:985-764-1422
Practice Address - Street 1:1972 ORMOND BLVD
Practice Address - Street 2:SUITE B
Practice Address - City:DESTREHAN
Practice Address - State:LA
Practice Address - Zip Code:70047-3818
Practice Address - Country:US
Practice Address - Phone:985-764-1441
Practice Address - Fax:985-764-1422
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-13
Last Update Date:2009-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty
No173F00000XOther Service ProvidersSleep Specialist, PhDGroup - Multi-Specialty
No2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Multi-Specialty