Individual
DR. PETER HAGERTY SHEA
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
12 CASE ST, STE 103, NORWICH, CT 06360
(860) 889-0147
(860) 887-7255
Mailing address
12 CASE ST, STE 103, NORWICH, CT 06360
(860) 889-0147
(860) 887-7255
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
243591
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
010024359CT01
ANTHEM BLUE CROSS
CT
Enumeration date
05/03/2006
Last updated
07/08/2007
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