Provider Demographics
NPI:1942466461
Name:WESTBERG, SHIRLEY L (MT)
Entity Type:Individual
Prefix:MRS
First Name:SHIRLEY
Middle Name:L
Last Name:WESTBERG
Suffix:
Gender:F
Credentials:MT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7401 WESTLAKE TER
Mailing Address - Street 2:#1012
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20817-6534
Mailing Address - Country:US
Mailing Address - Phone:302-365-9621
Mailing Address - Fax:
Practice Address - Street 1:7401 WESTLAKE TER
Practice Address - Street 2:#1012
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20817-6534
Practice Address - Country:US
Practice Address - Phone:302-365-9621
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-08-04
Last Update Date:2008-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDNONE246Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246Y00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, Health Information
Provider Identifiers
StateIdentifier IDID TypeIssuer
000000000OtherNONE