Provider Demographics
NPI:1568604932
Name:MATHEW, SHEMA JOSEPH (MD)
Entity Type:Individual
Prefix:DR
First Name:SHEMA
Middle Name:JOSEPH
Last Name:MATHEW
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:16404 SIGNATURE CT
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20853-3287
Mailing Address - Country:US
Mailing Address - Phone:301-538-0869
Mailing Address - Fax:301-774-5365
Practice Address - Street 1:10301 GEORGIA AVE
Practice Address - Street 2:SUITE #303
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20902-5020
Practice Address - Country:US
Practice Address - Phone:301-538-0869
Practice Address - Fax:301-774-5365
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-01
Last Update Date:2010-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0045362207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD417119500Medicaid