Provider Demographics
NPI:1679773154
Name:SHEILA M GUELDA MD PLLC
Entity type:Organization
Organization Name:SHEILA M GUELDA MD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHEILA
Authorized Official - Middle Name:M
Authorized Official - Last Name:GUELDA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:502-425-3600
Mailing Address - Street 1:2809 N HURSTBOURNE PKWY
Mailing Address - Street 2:SUITE 109
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40223-1279
Mailing Address - Country:US
Mailing Address - Phone:502-425-3600
Mailing Address - Fax:502-425-3601
Practice Address - Street 1:2809 N HURSTBOURNE PKWY
Practice Address - Street 2:SUITE 109
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40223-1279
Practice Address - Country:US
Practice Address - Phone:502-425-3600
Practice Address - Fax:502-425-3601
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-23
Last Update Date:2009-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY214892080A0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY50015784OtherPASSPORT