Provider Demographics
NPI:1831287945
Name:SHEETS, CLIFTON A (MD)
Entity Type:Individual
Prefix:
First Name:CLIFTON
Middle Name:A
Last Name:SHEETS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2511 SALEM CHURCH RD
Mailing Address - Street 2:
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22407-6466
Mailing Address - Country:US
Mailing Address - Phone:540-786-1200
Mailing Address - Fax:540-786-3195
Practice Address - Street 1:2511 SALEM CHURCH RD
Practice Address - Street 2:
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22407-6466
Practice Address - Country:US
Practice Address - Phone:540-786-1200
Practice Address - Fax:540-786-3195
Is Sole Proprietor?:No
Enumeration Date:2006-10-11
Last Update Date:2012-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101044230207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA011497P38Medicare PIN