Provider Demographics
NPI:1528192986
Name:BACHELDER, SHEILLA MARIE (MD)
Entity Type:Individual
Prefix:DR
First Name:SHEILLA
Middle Name:MARIE
Last Name:BACHELDER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 MASCOMA ST
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:NH
Mailing Address - Zip Code:03766-2647
Mailing Address - Country:US
Mailing Address - Phone:603-448-3121
Mailing Address - Fax:
Practice Address - Street 1:123 MASCOMA ST
Practice Address - Street 2:PHYSICIAN PRACTICES AT ALICE PECK DAY MEMORIAL HOSPITAL
Practice Address - City:LEBANON
Practice Address - State:NH
Practice Address - Zip Code:03766-2647
Practice Address - Country:US
Practice Address - Phone:603-448-3121
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-15
Last Update Date:2010-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VTBF4323200CW390200000X
NH14485207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
020222791OtherCBA
NH1528192986OtherANTHEM
AA155016OtherHARVARD PILGRIM
020222791OtherGREAT WEST
3009866OtherMVP
NH30208961Medicaid
020222791OtherINTEGRATED HEALTH
VT1016686Medicaid
020222791OtherCIGNA
VT1528192986OtherBCBS OF VT
020222791OtherMULTIPLAN
VT1016686Medicaid