Basic Information
Provider Information
NPI: 1902950900
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ANDERSON
FirstName: SHEILA
MiddleName: YVETTE
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2101 EAST JEFFERSON STREET
Address2: KAISER PERMANENTE, PPQA, 6 WEST
City: ROCKVILLE
State: MD
PostalCode: 20852
CountryCode: US
TelephoneNumber: 3018166660
FaxNumber: 3018166308
Practice Location
Address1: 110 IRVING STREET
Address2: SUITE 4B1
City: WASHINGTON
State: DC
PostalCode: 22010
CountryCode: US
TelephoneNumber: 2028775975
FaxNumber: 2028772718
Other Information
ProviderEnumerationDate: 01/23/2007
LastUpdateDate: 06/30/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 06/30/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000X0101237310VAN Allopathic & Osteopathic PhysiciansInternal Medicine 
207R00000XD62324MDN Allopathic & Osteopathic PhysiciansInternal Medicine 
207R00000XMD035236DCY Allopathic & Osteopathic PhysiciansInternal Medicine 

No ID Information.


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