Provider Demographics
NPI:1093404782
Name:DARBY-GILL, ENIDSIA SHEILA
Entity Type:Individual
Prefix:MRS
First Name:ENIDSIA
Middle Name:SHEILA
Last Name:DARBY-GILL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5745 E BONIWOOD TURN
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:MD
Mailing Address - Zip Code:20735-4153
Mailing Address - Country:US
Mailing Address - Phone:120-253-4898
Mailing Address - Fax:
Practice Address - Street 1:5745 E BONIWOOD TURN
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:MD
Practice Address - Zip Code:20735-4153
Practice Address - Country:US
Practice Address - Phone:120-253-4898
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-08
Last Update Date:2023-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC000000000171M00000X
171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor
No171M00000XOther Service ProvidersCase Manager/Care Coordinator