Provider Demographics
NPI:1912198219
Name:SCAVELLA, ARNETTE (MD)
Entity Type:Individual
Prefix:
First Name:ARNETTE
Middle Name:
Last Name:SCAVELLA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2221 HOUMA BLVD
Mailing Address - Street 2:APT 229
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70001-1378
Mailing Address - Country:US
Mailing Address - Phone:504-256-0371
Mailing Address - Fax:
Practice Address - Street 1:3515 HIGHWAY 1 SOUTH
Practice Address - Street 2:
Practice Address - City:PORT ALLEN
Practice Address - State:LA
Practice Address - Zip Code:70767
Practice Address - Country:US
Practice Address - Phone:225-749-5750
Practice Address - Fax:225-749-3138
Is Sole Proprietor?:No
Enumeration Date:2007-08-05
Last Update Date:2007-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAMD.200538208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1075027Medicaid