Individual
MICHAEL DALE SHEEHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4620 S LABURNUM AVE, RICHMOND, VA 23231-2424
(804) 652-2200
(804) 222-0458
Mailing address
4620 S LABURNUM AVE, RICHMOND, VA 23231-2424
(804) 652-2200
(804) 222-0458
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0101031406
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
005617600
—
VA
01
—
010060896
RAILROAD MEDICARE
VA
01
—
2650816
CIGNA
VA
01
—
293531
MAMSI
VA
01
—
333714
ANTHEM BC/BS OF VA
VA
01
—
4110560
AETNA LIFE
VA
01
—
45895
SENTARA
VA
01
—
79148
SOUTHERN HEALTH SERVICES
VA
Enumeration date
07/05/2006
Last updated
11/24/2009
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