Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NN0400X | Neurology | 4203-L | PA |
NPI | 1316947435 |
---|---|
Provider Name | Dr. Timothy Patrick Sheahan |
First Address | Gettysburg, PA 17325-8457 |
Second Address | Gettysburg, PA 17325-8457 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/07/2005 |
Last Update Date | 13/09/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
U01487 | (02) | PA |