Individual
MALACHI G. SHEAHAN, III III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1111 MEDICAL CENTER BLVD, SUITE N713, MARRERO, LA 70072-3151
(504) 349-6713
Mailing address
1340 POYDRAS ST, SUITE 1640, NEW ORLEANS, LA 70112-1221
(504) 412-1835
(504) 412-1954
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
15751R
LA
2086S0129X
Vascular Surgery Physician
Primary
MD.15751R
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
07776804
—
MS
05
—
1468088
—
LA
Enumeration date
08/10/2006
Last updated
03/08/2010
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