Provider Demographics
NPI:1780608653
Name:TEJEDOR, RICHARD STEVEN (MD)
Entity type:Individual
Prefix:
First Name:RICHARD
Middle Name:STEVEN
Last Name:TEJEDOR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1901 PERDIDO ST
Mailing Address - Street 2:SUITE 3205
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70112-1393
Mailing Address - Country:US
Mailing Address - Phone:228-363-0666
Mailing Address - Fax:
Practice Address - Street 1:1901 PERDIDO ST
Practice Address - Street 2:SUITE 3205
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70112-1393
Practice Address - Country:US
Practice Address - Phone:228-363-0666
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2023-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS11302207RC0200X, 207RP1001X
LA016551207RC0200X, 207RP1001X, 207RS0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1362719Medicaid
MS5Y832Medicaid
MS00118474Medicaid
MSB29923Medicare UPIN
MS5Y832Medicaid
LA376392YH3UMedicare PIN