Individual
DR. KEVIN P. SHEAHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
NEMOURS PEDIATRICS DOVER, 102 W. WATER STREET SUITE 1, DOVER, DE 19904-6750
(302) 672-5650
(302) 672-5655
Mailing address
PO BOX 191, PROVIDER ENROLLMENT DEPT, ROCKLAND, DE 19732-0191
(302) 651-6212
(302) 651-4945
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
C10004628
DE
208D00000X
General Practice Physician
Primary
C10004628
DE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001634033
—
PA
05
—
4173007
—
MD
05
—
7224001
—
NJ
Enumeration date
09/28/2006
Last updated
09/10/2011
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