Provider Demographics
NPI:1851450613
Name:HUNTER, MICHAEL SELWYN (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:SELWYN
Last Name:HUNTER
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 1:2610 ESPLANADE AVE
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70119-0000
Mailing Address - Country:US
Mailing Address - Phone:504-488-1779
Mailing Address - Fax:504-488-1785
Practice Address - Street 1:2610 ESPLANADE AVE
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70119
Practice Address - Country:US
Practice Address - Phone:504-488-1779
Practice Address - Fax:504-488-1785
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-07
Last Update Date:2011-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA017561207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1358151Medicaid
LA51257Medicare ID - Type Unspecified
LA1358151Medicaid