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General NPI Number Information
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NPI Number | 1407006695
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Entity Type | Organization
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Legal Business Name | SIDNEY SHANKMAN, MD PA
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Dates
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Enumeration Date | 09/24/2008
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Last Update Date | 09/24/2008
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Provider Practice Location Address
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Address Line | 8611 2ND AVE 301
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City | SILVER SPRING
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State | MD
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Zip | 20910-3372
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Country | US
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Telephone | 301-585-5365
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Fax | 301-588-4621
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Provider Business Mailing Address
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Address Line | 8611 2ND AVE 301
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City | SILVER SPRING
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State | MD
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Zip | 20910-3372
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Country | US
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Telephone | 301-585-5365
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Fax | 301-588-4621
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MRS. HARRIET P. SHEINSON
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Credential |
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Telephone | 301-585-5365
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | D0013486
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License Number State | MD
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