Provider Demographics
NPI:1104958347
Name:SHEMWELL, AMBER M (MD)
Entity type:Individual
Prefix:
First Name:AMBER
Middle Name:M
Last Name:SHEMWELL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:AMBER
Other - Middle Name:MOREAU
Other - Last Name:SALAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:312 GRAMMONT ST
Mailing Address - Street 2:SUITE 300
Mailing Address - City:MONROE
Mailing Address - State:LA
Mailing Address - Zip Code:71201-7403
Mailing Address - Country:US
Mailing Address - Phone:318-388-4030
Mailing Address - Fax:318-998-3999
Practice Address - Street 1:312 GRAMMONT ST STE 300
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:LA
Practice Address - Zip Code:71201-7403
Practice Address - Country:US
Practice Address - Phone:318-388-4030
Practice Address - Fax:318-325-8437
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-12
Last Update Date:2023-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM7586207V00000X
LA26538207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1059781Medicaid
LA4N108C148Medicare PIN
TX8J9050Medicare PIN