1942646567 NPI number — DR. MICHELLE ENGELHORN DUHE M.D.

Table of content: DR. MICHELLE ENGELHORN DUHE M.D. (NPI 1942646567)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1942646567 NPI number — DR. MICHELLE ENGELHORN DUHE M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
DUHE
Provider First Name:
MICHELLE
Provider Middle Name:
ENGELHORN
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
ENGELHORN
Provider Other First Name:
MICHELLE
Provider Other Middle Name:
NICHOLE
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1942646567
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/02/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5959 S SHERWOOD FOREST BLVD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BATON ROUGE
Provider Business Mailing Address State Name:
LA
Provider Business Mailing Address Postal Code:
70816-6038
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
225-526-0018
Provider Business Mailing Address Fax Number:
225-765-9468

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5000 ODONAVAN BLVD
Provider Second Line Business Practice Location Address:
SUITE 404
Provider Business Practice Location Address City Name:
WALKER
Provider Business Practice Location Address State Name:
LA
Provider Business Practice Location Address Postal Code:
70785-6351
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
225-765-5500
Provider Business Practice Location Address Fax Number:
225-369-8140
Provider Enumeration Date:
05/22/2013

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 390200000X , registered in the state of LA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207Q00000X , with the licence number: 304228 , registered in the state of LA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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