Provider Demographics
NPI:1083989339
Name:ANTONY, SHEILA (MD)
Entity Type:Individual
Prefix:
First Name:SHEILA
Middle Name:
Last Name:ANTONY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4100 E MISSISSIPPI AVE STE 110
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CO
Mailing Address - Zip Code:80246-3051
Mailing Address - Country:US
Mailing Address - Phone:303-552-9522
Mailing Address - Fax:720-729-7668
Practice Address - Street 1:4100 E MISSISSIPPI AVE STE 110
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CO
Practice Address - Zip Code:80246-3051
Practice Address - Country:US
Practice Address - Phone:303-552-9522
Practice Address - Fax:720-729-7668
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-20
Last Update Date:2023-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXT6182207R00000X
MA1015960207R00000X
CT53936207R00000X
AZ61325207R00000X
WAMD61172776207R00000X
GA90557207R00000X
390200000X
CODR.0056174207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program