Provider Demographics
NPI:1689659161
Name:MAURER, SHEILA MARIA (MD)
Entity Type:Individual
Prefix:
First Name:SHEILA
Middle Name:MARIA
Last Name:MAURER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:SHEILA
Other - Middle Name:
Other - Last Name:DATKO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:100 KIMEL FOREST DR
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27103-6074
Mailing Address - Country:US
Mailing Address - Phone:336-716-0238
Mailing Address - Fax:
Practice Address - Street 1:MEDICAL CENTER BLVD
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27157-5243
Practice Address - Country:US
Practice Address - Phone:336-713-4500
Practice Address - Fax:336-713-4501
Is Sole Proprietor?:No
Enumeration Date:2005-12-07
Last Update Date:2022-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2018-016382080S0012X, 2084P0800X, 2084P0804X, 2080P0214X, 2080S0012X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080S0012XAllopathic & Osteopathic PhysiciansPediatricsSleep Medicine
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
Yes2080P0214XAllopathic & Osteopathic PhysiciansPediatricsPediatric Pulmonology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR262478Medicaid
390200000XOtherPSYCHIATRY RESIDENT
390200000XOtherPSYCHIATRY RESIDENT
OR262478Medicaid