Provider Demographics
NPI:1427264969
Name:EAGAN, MICHELLE MANNING (MD)
Entity type:Individual
Prefix:DR
First Name:MICHELLE
Middle Name:MANNING
Last Name:EAGAN
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:5500 PRYTANIA ST # 412
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70115-4221
Mailing Address - Country:US
Mailing Address - Phone:504-459-1888
Mailing Address - Fax:504-459-1788
Practice Address - Street 1:15715 PROFESSIONAL PLZ
Practice Address - Street 2:
Practice Address - City:HAMMOND
Practice Address - State:LA
Practice Address - Zip Code:70403-1452
Practice Address - Country:US
Practice Address - Phone:504-459-1888
Practice Address - Fax:504-459-1788
Is Sole Proprietor?:No
Enumeration Date:2007-05-14
Last Update Date:2020-05-18
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
LA311172208200000X
MO2014007658208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery