Provider Demographics
NPI:1265691687
Name:SPEARS, RACHEL SHELEA (MD)
Entity type:Individual
Prefix:DR
First Name:RACHEL
Middle Name:SHELEA
Last Name:SPEARS
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 1:1101 MEDICAL CENTER BLVD.
Mailing Address - Street 2:
Mailing Address - City:MARRERO
Mailing Address - State:LA
Mailing Address - Zip Code:70072
Mailing Address - Country:US
Mailing Address - Phone:504-349-6945
Mailing Address - Fax:504-349-6949
Practice Address - Street 1:1111 MEDICAL CENTER BLVD.
Practice Address - Street 2:STE. S250
Practice Address - City:MARRERO
Practice Address - State:LA
Practice Address - Zip Code:70072
Practice Address - Country:US
Practice Address - Phone:504-349-6945
Practice Address - Fax:504-349-6949
Is Sole Proprietor?:No
Enumeration Date:2008-06-02
Last Update Date:2015-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAPGY 1 PERMIT390200000X
LA205306207VG0400X
LAMD.205306207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1102784Medicaid