Individual
DR. ANDREW BLAKE SHOLL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2915 MISSOURI AVE, SHREVEPORT, LA 71109-4327
(318) 621-8820
Mailing address
PO BOX 3780, TUPELO, MS 38803-3780
(318) 841-9526
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
DR.0050723
CO
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
MD.206511
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2346202
—
LA
Enumeration date
04/03/2008
Last updated
09/12/2019
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