Provider Demographics
NPI:1750467387
Name:VERGHESE MATHEW, SHEILA (MD)
Entity Type:Individual
Prefix:
First Name:SHEILA
Middle Name:
Last Name:VERGHESE MATHEW
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:SHEILA
Other - Middle Name:
Other - Last Name:VERGHESE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:2344 BEAVER CREEK
Mailing Address - Street 2:
Mailing Address - City:WESTLAKE
Mailing Address - State:OH
Mailing Address - Zip Code:44145
Mailing Address - Country:US
Mailing Address - Phone:440-835-6263
Mailing Address - Fax:440-892-6632
Practice Address - Street 1:3090 WEST MARKET STREET
Practice Address - Street 2:
Practice Address - City:FAIRLAWN
Practice Address - State:OH
Practice Address - Zip Code:44333
Practice Address - Country:US
Practice Address - Phone:330-873-4866
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35036934207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology