Provider Demographics
NPI:1457710741
Name:MADEIRA, SHEILA
Entity type:Individual
Prefix:
First Name:SHEILA
Middle Name:
Last Name:MADEIRA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2225 OLD EMMORTON RD
Mailing Address - Street 2:
Mailing Address - City:BEL AIR
Mailing Address - State:MD
Mailing Address - Zip Code:21015-6129
Mailing Address - Country:US
Mailing Address - Phone:410-508-0722
Mailing Address - Fax:410-834-1851
Practice Address - Street 1:2225 OLD EMMORTON RD
Practice Address - Street 2:
Practice Address - City:BEL AIR
Practice Address - State:MD
Practice Address - Zip Code:21015-6129
Practice Address - Country:US
Practice Address - Phone:410-508-0722
Practice Address - Fax:410-834-1851
Is Sole Proprietor?:No
Enumeration Date:2016-02-16
Last Update Date:2025-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR171960363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health