Provider Demographics
NPI:1528048642
Name:RODTS-PALENIK, SHERYL ELAINE (MD)
Entity type:Individual
Prefix:
First Name:SHERYL
Middle Name:ELAINE
Last Name:RODTS-PALENIK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 PATRIOT ST STE 203
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70508-6831
Mailing Address - Country:US
Mailing Address - Phone:337-989-9826
Mailing Address - Fax:337-989-9829
Practice Address - Street 1:105 PATRIOT ST STE 203
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70508-6831
Practice Address - Country:US
Practice Address - Phone:337-989-9826
Practice Address - Fax:337-989-9829
Is Sole Proprietor?:No
Enumeration Date:2006-01-17
Last Update Date:2022-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA15090R207VM0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VM0101XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyMaternal & Fetal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1159964Medicaid
LAG74077Medicare UPIN
LA1159964Medicaid