Healthcare Provider Details

I. General information

NPI: 1275599862
Provider Name (Legal Business Name): SHEILA A CEPEDA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/24/2006
Last Update Date: 05/25/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

465 SAINT MICHAELS DR
SANTA FE NM
87505-7670
US

IV. Provider business mailing address

465 SAINT MICHAELS DR
SANTA FE NM
87505-7670
US

V. Phone/Fax

Practice location:
  • Phone: 505-984-0303
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number99177
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: