Provider Demographics
NPI:1689886095
Name:DUNNIGAN, SHARON
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:
Last Name:DUNNIGAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 116
Mailing Address - Street 2:
Mailing Address - City:MOODY
Mailing Address - State:ME
Mailing Address - Zip Code:04054-0116
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:207-351-3434
Practice Address - Street 1:15 HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:ME
Practice Address - Zip Code:03909-1011
Practice Address - Country:US
Practice Address - Phone:207-351-2150
Practice Address - Fax:207-351-3434
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME4198183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist