Provider Demographics
NPI:1013375336
Name:KLASSEN, SHEILA (MD)
Entity Type:Individual
Prefix:DR
First Name:SHEILA
Middle Name:
Last Name:KLASSEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MS
Other - First Name:SHEILA
Other - Middle Name:
Other - Last Name:LIU
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:75 FRANCIS ST
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02115-6110
Mailing Address - Country:US
Mailing Address - Phone:617-732-5500
Mailing Address - Fax:
Practice Address - Street 1:75 FRANCIS ST
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02115-6110
Practice Address - Country:US
Practice Address - Phone:617-732-5500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-01
Last Update Date:2023-06-29
Deactivation Date:2017-04-05
Deactivation Code:
Reactivation Date:2017-11-29
Provider Licenses
StateLicense IDTaxonomies
390200000X
MA295379207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program