Provider Demographics
NPI:1821019217
Name:HERSH, SHELDON M (MD)
Entity Type:Individual
Prefix:
First Name:SHELDON
Middle Name:M
Last Name:HERSH
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 1:506 SHORT ST
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70118-2723
Mailing Address - Country:US
Mailing Address - Phone:504-723-5099
Mailing Address - Fax:504-617-6505
Practice Address - Street 1:1301 SIMON BOLIVAR AVE
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70113-2222
Practice Address - Country:US
Practice Address - Phone:504-723-5099
Practice Address - Fax:504-617-6505
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-21
Last Update Date:2010-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA013429207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1172481Medicaid
LA52952Medicare ID - Type Unspecified
LAB89572Medicare UPIN