Provider Demographics
NPI:1508859257
Name:MILNER, SHELDON DALE (MD)
Entity Type:Individual
Prefix:DR
First Name:SHELDON
Middle Name:DALE
Last Name:MILNER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2214 CREST RD
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21209-4207
Mailing Address - Country:US
Mailing Address - Phone:410-687-2300
Mailing Address - Fax:410-687-1778
Practice Address - Street 1:9110 PHILADELPHIA RD
Practice Address - Street 2:SUITE 206
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21237-4301
Practice Address - Country:US
Practice Address - Phone:410-687-2300
Practice Address - Fax:410-687-1778
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-29
Last Update Date:2007-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD18598207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
C49267Medicare UPIN
571M886FMedicare PIN