Provider Demographics
NPI:1851700371
Name:PROSSER, SHEELAGH (MD)
Entity Type:Individual
Prefix:
First Name:SHEELAGH
Middle Name:
Last Name:PROSSER
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 1:66 SPRUCE ST
Mailing Address - Street 2:
Mailing Address - City:PRESQUE ISLE
Mailing Address - State:ME
Mailing Address - Zip Code:04769-3243
Mailing Address - Country:US
Mailing Address - Phone:207-769-2025
Mailing Address - Fax:207-764-0629
Practice Address - Street 1:66 SPRUCE ST
Practice Address - Street 2:
Practice Address - City:PRESQUE ISLE
Practice Address - State:ME
Practice Address - Zip Code:04769-3243
Practice Address - Country:US
Practice Address - Phone:207-769-2025
Practice Address - Fax:207-764-0629
Is Sole Proprietor?:No
Enumeration Date:2014-08-08
Last Update Date:2015-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEMD14454207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine