Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0106X | Oral and Maxillofacial Pathology | DS024305L | PA |
NPI | 1902854839 |
---|---|
Provider Name | Dr. Thomas Patrick Sheeran |
First Address | Trappe, PA 19426-1981 |
Second Address | Collegeville, PA 19426-1981 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/05/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
U09378 | (02) | PA |