Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2080N0001X | Neonatal-Perinatal Doctor | 04-16863 | KS |
Y | 2080N0001X | Neonatal-Perinatal Doctor | R6998 | MO |
NPI | 1134186059 |
---|---|
Provider Name | Michael B Sheehan |
First Address | Kansas City, MO 64108-4619 |
Second Address | Kansas City, MO 64108-4619 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/04/2006 |
Last Update Date | 14/06/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
100002550A | (05) | KS |
200683118 | (05) | MO |
F47763 | (02) | MO |