Provider Demographics
NPI:1295824712
Name:MCGINNIS, SHEILA M (PA-C)
Entity Type:Individual
Prefix:MS
First Name:SHEILA
Middle Name:M
Last Name:MCGINNIS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4830 LONDONDERRY RD
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17109-5207
Mailing Address - Country:US
Mailing Address - Phone:717-657-2595
Mailing Address - Fax:717-441-0116
Practice Address - Street 1:4830 LONDONDERRY RD
Practice Address - Street 2:
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17109-5207
Practice Address - Country:US
Practice Address - Phone:717-657-2595
Practice Address - Fax:717-441-0116
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA003221L363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAP00221Medicare UPIN
PA092182Medicare ID - Type Unspecified