Provider Demographics
NPI:1790784601
Name:SCHABELMAN, SERGIO EDUARDO (MD)
Entity Type:Individual
Prefix:DR
First Name:SERGIO
Middle Name:EDUARDO
Last Name:SCHABELMAN
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 1:200 WEST ESPLANADE AVE
Mailing Address - Street 2:SUITE 405
Mailing Address - City:KENNER
Mailing Address - State:LA
Mailing Address - Zip Code:70065
Mailing Address - Country:US
Mailing Address - Phone:504-305-3500
Mailing Address - Fax:504-305-3503
Practice Address - Street 1:200 WEST ESPLANADE AVE
Practice Address - Street 2:SUITE 405
Practice Address - City:KENNER
Practice Address - State:LA
Practice Address - Zip Code:70065
Practice Address - Country:US
Practice Address - Phone:504-305-3500
Practice Address - Fax:504-305-3502
Is Sole Proprietor?:No
Enumeration Date:2005-07-21
Last Update Date:2011-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA04596R207RC0000X
LAL04596R207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA060000728OtherMEDICARE RAILROAD
LA1194026Medicaid
LAA27212Medicare UPIN
LA5K412Medicare PIN