Provider Demographics
NPI:1760712525
Name:SEAMANS, SHAWN D SR
Entity Type:Individual
Prefix:MR
First Name:SHAWN
Middle Name:D
Last Name:SEAMANS
Suffix:SR
Gender:M
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 3573
Mailing Address - Street 2:
Mailing Address - City:BREWER
Mailing Address - State:ME
Mailing Address - Zip Code:04412-3573
Mailing Address - Country:US
Mailing Address - Phone:207-989-7997
Mailing Address - Fax:
Practice Address - Street 1:378 LEVENSELLER RD
Practice Address - Street 2:
Practice Address - City:HOLDEN
Practice Address - State:ME
Practice Address - Zip Code:04429-7306
Practice Address - Country:US
Practice Address - Phone:207-989-7997
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-30
Last Update Date:2009-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities