Provider Demographics
NPI:1447695937
Name:VIVEKANANDAN, SHEELA (MD)
Entity type:Individual
Prefix:
First Name:SHEELA
Middle Name:
Last Name:VIVEKANANDAN
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2005 TECHNOLOGY PKWY STE 100
Mailing Address - Street 2:
Mailing Address - City:MECHANICSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17050-9413
Mailing Address - Country:US
Mailing Address - Phone:717-988-9370
Mailing Address - Fax:717-703-0154
Practice Address - Street 1:2005 TECHNOLOGY PKWY STE 100
Practice Address - Street 2:
Practice Address - City:MECHANICSBURG
Practice Address - State:PA
Practice Address - Zip Code:17050-9413
Practice Address - Country:US
Practice Address - Phone:717-988-9370
Practice Address - Fax:717-703-0154
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-09
Last Update Date:2025-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT12806169-1205207T00000X
PAMD479467207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery