Individual
ELENA MERCEDES SHEA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
8640 SUDLEY RD STE 306, MANASSAS, VA 20110-4404
(703) 330-3939
Mailing address
8640 SUDLEY RD, SUITE 306, MANASSAS, VA 20110-4420
(703) 330-3939
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
0101249728
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0101249758
VA LICENSE
VA
05
—
1235390097
—
VA
Enumeration date
06/24/2008
Last updated
07/02/2020
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