Provider Demographics
NPI:1538225628
Name:BARNES, SHEILA ANNETTE (DO)
Entity type:Individual
Prefix:DR
First Name:SHEILA
Middle Name:ANNETTE
Last Name:BARNES
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:495 E MOUND ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43215-5540
Mailing Address - Country:US
Mailing Address - Phone:614-464-0964
Mailing Address - Fax:
Practice Address - Street 1:495 E MOUND ST
Practice Address - Street 2:SUITE B
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43215-5540
Practice Address - Country:US
Practice Address - Phone:614-464-0964
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34-00-4656B207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0743539Medicaid
OHE54257Medicare UPIN
OH0743539Medicaid