Provider Demographics
NPI:1093013187
Name:DAVIS, SHEILAH NICOLE (PT)
Entity Type:Individual
Prefix:DR
First Name:SHEILAH
Middle Name:NICOLE
Last Name:DAVIS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:ATI PHYSICAL THERAPY
Mailing Address - Street 2:22750-D1 NEWCUT ROAD
Mailing Address - City:CLARKSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20871
Mailing Address - Country:US
Mailing Address - Phone:301-250-2146
Mailing Address - Fax:240-261-5322
Practice Address - Street 1:ATI PHYSICAL THERAPY
Practice Address - Street 2:22750-D1 NEWCUT ROAD
Practice Address - City:CLARKSBURG
Practice Address - State:MD
Practice Address - Zip Code:20871
Practice Address - Country:US
Practice Address - Phone:301-250-2146
Practice Address - Fax:240-261-5322
Is Sole Proprietor?:No
Enumeration Date:2011-03-14
Last Update Date:2021-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD19167225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDP00965235OtherRAILROAD MEDICARE