Provider Demographics
NPI:1215135470
Name:KADEKAR, SHEELA (MD)
Entity type:Individual
Prefix:
First Name:SHEELA
Middle Name:
Last Name:KADEKAR
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 1:5675 STONE RD
Mailing Address - Street 2:SUITE 320
Mailing Address - City:CENTREVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:20120-1667
Mailing Address - Country:US
Mailing Address - Phone:703-402-2513
Mailing Address - Fax:703-830-0001
Practice Address - Street 1:5675 STONE RD
Practice Address - Street 2:SUITE 320
Practice Address - City:CENTREVILLE
Practice Address - State:VA
Practice Address - Zip Code:20120-1667
Practice Address - Country:US
Practice Address - Phone:703-402-2513
Practice Address - Fax:703-830-0001
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-10
Last Update Date:2009-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01012400662084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry