Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | D0070001 | MD |
N | 2080A0000X | Adolescent Medicine | D0070001 | MD |
NPI | 1144384371 |
---|---|
Provider Name | Sushila Sheoran |
First Address | Potomac, MD 20854-3343 |
Second Address | Rockville, MD 20852-3142 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/12/2006 |
Last Update Date | 16/09/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
420573100 | (05) | MD |