Provider Demographics
NPI:1144360587
Name:VANMILDER, SHIRLEY ANNE (MD)
Entity type:Individual
Prefix:DR
First Name:SHIRLEY
Middle Name:ANNE
Last Name:VANMILDER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2101 EAST JEFFERSON STREET
Mailing Address - Street 2:KAISER PERMANENTE, PPQA, 6 WEST,
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20852
Mailing Address - Country:US
Mailing Address - Phone:301-816-6660
Mailing Address - Fax:301-816-6308
Practice Address - Street 1:1221 MERCANTILE LANE
Practice Address - Street 2:
Practice Address - City:LARGO
Practice Address - State:MD
Practice Address - Zip Code:20774
Practice Address - Country:US
Practice Address - Phone:301-618-5679
Practice Address - Fax:301-618-5673
Is Sole Proprietor?:No
Enumeration Date:2007-02-07
Last Update Date:2021-06-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDD64875207V00000X
DCMD036422207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology