Provider Demographics
NPI:1568633162
Name:SHEEHAN, JAMES DAVID (NMD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:DAVID
Last Name:SHEEHAN
Suffix:
Gender:M
Credentials:NMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1845 S DOBSON RD
Mailing Address - Street 2:202
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85202-5661
Mailing Address - Country:US
Mailing Address - Phone:480-413-9000
Mailing Address - Fax:480-413-2060
Practice Address - Street 1:1845 S DOBSON RD
Practice Address - Street 2:202
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85202-5661
Practice Address - Country:US
Practice Address - Phone:480-413-9000
Practice Address - Fax:480-413-2060
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-22
Last Update Date:2008-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ06-910175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath