Provider Demographics
NPI:1164838249
Name:CRAIG WHITEMAN, SHELIA (PT,DPT)
Entity Type:Individual
Prefix:
First Name:SHELIA
Middle Name:
Last Name:CRAIG WHITEMAN
Suffix:
Gender:F
Credentials:PT,DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3202 SHORTRIDGE LN
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20721-2574
Mailing Address - Country:US
Mailing Address - Phone:301-249-7437
Mailing Address - Fax:
Practice Address - Street 1:1106 ANNAPOLIS RD
Practice Address - Street 2:
Practice Address - City:ODENTON
Practice Address - State:MD
Practice Address - Zip Code:21113-1637
Practice Address - Country:US
Practice Address - Phone:301-249-7437
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-09
Last Update Date:2014-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD18705225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist