Healthcare Provider Details

I. General information

NPI: 1710088612
Provider Name (Legal Business Name): DOLORES O'NEILL SHEFF PA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/26/2006
Last Update Date: 04/10/2020
Certification Date: 04/10/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

53 S MEDICAL PARK DR
FISHERSVILLE VA
22939-2333
US

IV. Provider business mailing address

PO BOX 388
FISHERSVILLE VA
22939-0388
US

V. Phone/Fax

Practice location:
  • Phone: 540-332-5687
  • Fax: 540-332-5688
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number004674
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number011002217
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: