Provider Demographics
NPI:1699920124
Name:SPILMAN, SHIRA (PA-C)
Entity type:Individual
Prefix:
First Name:SHIRA
Middle Name:
Last Name:SPILMAN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:12510 PROSPERITY DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20904-1663
Mailing Address - Country:US
Mailing Address - Phone:240-485-5200
Mailing Address - Fax:301-625-6906
Practice Address - Street 1:9420 KEY WEST AVENUE
Practice Address - Street 2:SUITE 202
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-6288
Practice Address - Country:US
Practice Address - Phone:301-251-9555
Practice Address - Fax:301-309-0765
Is Sole Proprietor?:No
Enumeration Date:2008-11-25
Last Update Date:2016-07-11
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAMA053634363A00000X
MDC0004227363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant