Provider Demographics
NPI:1659699254
Name:HOWARD, SHEANITA R (MD)
Entity type:Individual
Prefix:
First Name:SHEANITA
Middle Name:R
Last Name:HOWARD
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 1:1460 RITCHIE HIGHWAY
Mailing Address - Street 2:ST 209
Mailing Address - City:ARNOLD
Mailing Address - State:MD
Mailing Address - Zip Code:21012
Mailing Address - Country:US
Mailing Address - Phone:410-789-7337
Mailing Address - Fax:410-349-1107
Practice Address - Street 1:1460 RITCHIE HWY STE 209
Practice Address - Street 2:
Practice Address - City:ARNOLD
Practice Address - State:MD
Practice Address - Zip Code:21012-2741
Practice Address - Country:US
Practice Address - Phone:410-789-7337
Practice Address - Fax:410-349-1107
Is Sole Proprietor?:No
Enumeration Date:2010-05-07
Last Update Date:2024-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD00762892080A0000X, 2080A0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD114350600Medicaid