Provider Demographics
NPI:1679553887
Name:SHEEHAN, DOUGLAS PAUL (DPM)
Entity type:Individual
Prefix:DR
First Name:DOUGLAS
Middle Name:PAUL
Last Name:SHEEHAN
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:250 FAME AVE
Mailing Address - Street 2:SUITE 220
Mailing Address - City:HANOVER
Mailing Address - State:PA
Mailing Address - Zip Code:17331-1587
Mailing Address - Country:US
Mailing Address - Phone:717-632-5264
Mailing Address - Fax:717-632-1165
Practice Address - Street 1:250 FAME AVE
Practice Address - Street 2:SUITE 220
Practice Address - City:HANOVER
Practice Address - State:PA
Practice Address - Zip Code:17331-1587
Practice Address - Country:US
Practice Address - Phone:717-632-5264
Practice Address - Fax:717-632-1165
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-23
Last Update Date:2013-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASC003296L213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD234094OtherOPTIMUM CHOICE
PA232815860OtherSOUTH CENTRAL PREFERRED
PA50000708OtherCAPITAL BLUE CROSS
PA610215OtherFEDERAL BC/BS
PA1493380OtherCIGNA
KY232815860OtherHEALTH ASSURANCE/AMERICA
PA610215OtherKEYSTONE
PA781462OtherAMERIHEALTH ADMINISTRATOR
MD234094OtherALLIANCE
GA480009391OtherMEDICARE RAILROAD
SC232815860OtherTRICARE REGION 1
PA232815860OtherCORESOURCE
MD234094OtherMAMSI
MD52383502OtherBLUE CROSS/BLUE SHIELD MD
DCT381OtherCAREFIRST BC/BS DC
PA610215OtherHIGHMARK
PA610215OtherFEDERAL BC/BS
PA610215OtherHIGHMARK