Provider Demographics
NPI:1164749909
Name:PINSKY, MICHAEL R (MD)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:R
Last Name:PINSKY
Suffix:
Gender:M
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 1:4315 HOUMA BLVD STE 302
Mailing Address - Street 2:
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70006-2944
Mailing Address - Country:US
Mailing Address - Phone:504-455-2800
Mailing Address - Fax:504-780-2258
Practice Address - Street 1:215 E GIBSON ST
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:LA
Practice Address - Zip Code:70433-2823
Practice Address - Country:US
Practice Address - Phone:985-892-4544
Practice Address - Fax:985-773-1998
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-03
Last Update Date:2025-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAMD.204804208800000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA2108972Medicaid
MS03772070Medicaid
MS03772070Medicaid