Provider Demographics
NPI:1275565194
Name:KILBANE, SHEILA ANN (MD)
Entity Type:Individual
Prefix:DR
First Name:SHEILA
Middle Name:ANN
Last Name:KILBANE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:8605 CLIFF CAMERON DR
Mailing Address - Street 2:SUITE 120
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28269-0014
Mailing Address - Country:US
Mailing Address - Phone:704-548-9947
Mailing Address - Fax:704-547-9785
Practice Address - Street 1:8605 CLIFF CAMERON DR
Practice Address - Street 2:SUITE 120
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28269-0014
Practice Address - Country:US
Practice Address - Phone:704-548-9947
Practice Address - Fax:704-547-9785
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2012-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2005-01217208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5902418Medicaid
NC2418OtherBCBS
NCI44908Medicare UPIN