Provider Demographics
NPI:1831246818
Name:ABRAHAM, SHEENA (MD)
Entity type:Individual
Prefix:DR
First Name:SHEENA
Middle Name:
Last Name:ABRAHAM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12797 OWLSLEY WAY
Mailing Address - Street 2:
Mailing Address - City:OAK HILL
Mailing Address - State:VA
Mailing Address - Zip Code:20171-4223
Mailing Address - Country:US
Mailing Address - Phone:703-726-2566
Mailing Address - Fax:703-726-1066
Practice Address - Street 1:43490 YUKON DR.
Practice Address - Street 2:SUITE 210
Practice Address - City:ASHBURN
Practice Address - State:VA
Practice Address - Zip Code:20147
Practice Address - Country:US
Practice Address - Phone:703-726-2566
Practice Address - Fax:703-726-1066
Is Sole Proprietor?:No
Enumeration Date:2007-01-04
Last Update Date:2010-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101056851207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1831246818Medicaid
00X408V01Medicare PIN
G90830Medicare UPIN