Healthcare Provider Details

I. General information

NPI: 1245299270
Provider Name (Legal Business Name): SHEILA MARIE ANDERSON DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/20/2006
Last Update Date: 03/02/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 WILSON ROAD
BENTLEYVILLE PA
15314-1028
US

IV. Provider business mailing address

1070 OLD NATIONAL PIKE RD
FREDERICKTOWN PA
15333-2114
US

V. Phone/Fax

Practice location:
  • Phone: 724-239-2390
  • Fax: 724-239-2393
Mailing address:
  • Phone: 724-632-6801
  • Fax: 724-632-6312

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberOS010327L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: