Provider Demographics
NPI:1528151792
Name:OWEN SHEEKEY MD LLC
Entity type:Organization
Organization Name:OWEN SHEEKEY MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:OWEN
Authorized Official - Middle Name:J
Authorized Official - Last Name:SHEEKEY
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:856-696-2232
Mailing Address - Street 1:1138 E CHESTNUT AVE
Mailing Address - Street 2:SUITE 8A
Mailing Address - City:VINELAND
Mailing Address - State:NJ
Mailing Address - Zip Code:08360-5053
Mailing Address - Country:US
Mailing Address - Phone:856-696-2232
Mailing Address - Fax:856-696-8052
Practice Address - Street 1:1138 E CHESTNUT AVE
Practice Address - Street 2:SUITE 8A
Practice Address - City:VINELAND
Practice Address - State:NJ
Practice Address - Zip Code:08360-5053
Practice Address - Country:US
Practice Address - Phone:856-696-2232
Practice Address - Fax:856-696-8052
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA031034207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJSH3977901Medicaid
SH561732Medicare ID - Type Unspecified
DO6940Medicare UPIN