Healthcare Provider Details

I. General information

NPI: 1710959366
Provider Name (Legal Business Name): SHEILA Y OWENS-COLLINS MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/07/2006
Last Update Date: 09/01/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1150 VARNUM STREET, NE ST. CATHERINE'S HALL/1ST FLOOR/ROOM 102
WASHINGTON DC
20017-2104
US

IV. Provider business mailing address

402 KING FARM BLVD SUITE 125-144
ROCKVILLE MD
20850-5843
US

V. Phone/Fax

Practice location:
  • Phone: 202-854-4812
  • Fax: 202-854-7825
Mailing address:
  • Phone: 301-251-4712
  • Fax: 301-251-4718

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2080N0001X
TaxonomyNeonatal-Perinatal Medicine Physician
License NumberE8788
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code2080N0001X
TaxonomyNeonatal-Perinatal Medicine Physician
License Number36112572IL
License Number StateIL
# 3
Primary TaxonomyY
Taxonomy Code2080N0001X
TaxonomyNeonatal-Perinatal Medicine Physician
License NumberMD042164
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: