Provider Demographics
NPI:1639296312
Name:SHARKEY, HEATHER A (DO)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:A
Last Name:SHARKEY
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:60 FOREST FALLS DR STE 5
Mailing Address - Street 2:
Mailing Address - City:YARMOUTH
Mailing Address - State:ME
Mailing Address - Zip Code:04096-6971
Mailing Address - Country:US
Mailing Address - Phone:207-847-9200
Mailing Address - Fax:207-847-9315
Practice Address - Street 1:60 FOREST FALLS DR STE 5
Practice Address - Street 2:
Practice Address - City:YARMOUTH
Practice Address - State:ME
Practice Address - Zip Code:04096-6971
Practice Address - Country:US
Practice Address - Phone:207-847-9200
Practice Address - Fax:207-847-9315
Is Sole Proprietor?:No
Enumeration Date:2007-03-26
Last Update Date:2022-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEDO2042207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME000632203Medicare PIN