Provider Demographics
NPI:1366718603
Name:HEWITT, ROBERT L (MD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:L
Last Name:HEWITT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1750 ST. CHARLES AVENUE
Mailing Address - Street 2:#202
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70130
Mailing Address - Country:US
Mailing Address - Phone:504-680-8451
Mailing Address - Fax:
Practice Address - Street 1:1750 ST. CHARLES AVENUE
Practice Address - Street 2:#202
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70130
Practice Address - Country:US
Practice Address - Phone:504-680-8451
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-30
Last Update Date:2012-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA008497208600000X, 2086S0129X, 208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgery
No208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)