Provider Demographics
NPI:1710959366
Name:OWENS-COLLINS, SHEILA Y (MD)
Entity Type:Individual
Prefix:
First Name:SHEILA
Middle Name:Y
Last Name:OWENS-COLLINS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:402 KING FARM BLVD
Mailing Address - Street 2:SUITE 125-144
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20850-5843
Mailing Address - Country:US
Mailing Address - Phone:301-251-4712
Mailing Address - Fax:301-251-4718
Practice Address - Street 1:1150 VARNUM STREET, NE
Practice Address - Street 2:ST. CATHERINE'S HALL/1ST FLOOR/ROOM 102
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20017-2104
Practice Address - Country:US
Practice Address - Phone:202-854-4812
Practice Address - Fax:202-854-7825
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-07
Last Update Date:2016-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE87882080N0001X
IL36112572IL2080N0001X
DCMD0421642080N0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036112572Medicaid
TX98700367Medicaid