Provider Demographics
NPI:1922129444
Name:SHIELDS-DAVIS, SHARIKA (OD)
Entity Type:Individual
Prefix:DR
First Name:SHARIKA
Middle Name:
Last Name:SHIELDS-DAVIS
Suffix:
Gender:F
Credentials:OD
Other - Prefix:DR
Other - First Name:SHARIKA
Other - Middle Name:
Other - Last Name:SHIELDS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:13209 5TH ST
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20720-3609
Mailing Address - Country:US
Mailing Address - Phone:240-929-4255
Mailing Address - Fax:240-929-4316
Practice Address - Street 1:3300 CRAIN HWY
Practice Address - Street 2:VISION CENTER
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20716-1398
Practice Address - Country:US
Practice Address - Phone:301-805-8238
Practice Address - Fax:301-805-0285
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-02
Last Update Date:2023-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDTA2138152W00000X
PAOEG001887152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist